Spitzmiller R Edwin, Phillips Tonya, Meinzen-Derr Jareen, Hoath Steven B
Department of Pediatrics, Division of Neonatology, University of Cincinnati and the Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Child Neurol. 2007 Sep;22(9):1069-78. doi: 10.1177/0883073807306258.
Hypoxic ischemic encephalopathy is a common cause of neurological complications resulting in chronic handicapping conditions, such as cerebral palsy. Amplitude-integrated electroencephalography (EEG) has been used in many European countries for more than a decade in the evaluation of infants with hypoxic ischemic encephalopathy but has not been widely used in the United States. The objective of this study was to evaluate the evidence supporting use of amplitude-integrated EEG as a quantitative predictor of neurodevelopmental outcome in full-term infants with hypoxic ischemic encephalopathy. To assess efficacy, the authors performed a meta-analysis of the literature evaluating the use of the amplitude-integrated EEG or cerebral function monitor in full-term infants with hypoxic ischemic encephalopathy and their neurodevelopmental outcome. A total of 8 studies were eligible for the primary meta-analysis. There was an overall sensitivity of 91% (95% CI 87-95) and a negative likelihood ratio of 0.09 (95% CI .06-.15) for amplitude-integrated EEG tracings to accurately predict poor outcome. Amplitude-integrated EEG is a valuable bedside tool for predicting long-term neurodevelopmental outcome in term infants with hypoxic ischemic encephalopathy. This information is useful in structuring communication and care plans for physicians and parents. Early assessment techniques such as amplitude-integrated EEG provide objective means for determining inclusion in clinical studies evaluating therapies for hypoxic ischemic encephalopathy and for predicting which patients are most likely to respond to treatment.
缺氧缺血性脑病是导致慢性残疾状况（如脑瘫）的神经并发症的常见原因。振幅整合脑电图（EEG）在许多欧洲国家已被用于评估缺氧缺血性脑病婴儿超过十年，但在美国尚未广泛使用。本研究的目的是评估支持将振幅整合脑电图作为足月缺氧缺血性脑病婴儿神经发育结局定量预测指标的证据。为了评估疗效，作者对评估振幅整合脑电图或脑功能监测仪在足月缺氧缺血性脑病婴儿中的应用及其神经发育结局的文献进行了荟萃分析。共有8项研究符合初步荟萃分析的条件。振幅整合脑电图描记图准确预测不良结局的总体敏感性为91%（95%CI 87-95），阴性似然比为0.09（95%CI 0.06-0.15）。振幅整合脑电图是预测足月缺氧缺血性脑病婴儿长期神经发育结局的有价值的床边工具。这些信息有助于为医生和家长制定沟通和护理计划。诸如振幅整合脑电图等早期评估技术为确定纳入评估缺氧缺血性脑病治疗方法的临床研究以及预测哪些患者最可能对治疗有反应提供了客观手段。
