Scoppa A, Casani A, Cocca F, Coletta C, De Luca M G, Di Manso G, Grappone L, Pozzi N, Orfeo L
Neonatal Intensive Care Unit, Azienda Ospedaliera G. Rummo, Benevento, Italy.
J Matern Fetal Neonatal Med. 2012 Oct;25 Suppl 4:139-40. doi: 10.3109/14767058.2012.714971.
Over the last decade, the survival of premature babies has improved dramatically. Such infants, especially those with extremely low birth weight, are still affected by dangerous complications occurring during the neonatal period that often cause brain damage. Intraventricular-intraparenchymal haemorrhage (IVH-IPH), periventricular leukomalacia (PVL), seizures, meningitis and hypoxic-ischaemic encephalopathy are the most common complications. Such problems require more specialized monitoring of brain function during this critical period. In recent years, many studies on very premature infants have shown that aEEG has a high predictive value for both short-term and long-term outcome. In fact, it has been proven that some types of background activity patterns, the absence of a sleep-wake cycle, and seizure activity are related to the onset of early complications such as IVH-IPH and PVL. Most recent studies have shown that an aEEG performed in the early hours or during the first days of life can predict the neurobehavioural development of preterm infants at 2 years and 3 years (Bayley Scale). In particular our study demonstrates that loss of sleep-wake cycling, shown by aEEG, has a high positive predictive value for the development of posthaemorrhagic hydrocephalus (PPH) in preterm infants with IVH; therefore, the study of cerebral background activity and in particular of sleep-wake cycling can be used as an early prognostic tool in patients at risk of PPH.
在过去十年中,早产儿的存活率有了显著提高。这类婴儿,尤其是那些出生体重极低的婴儿,仍然受到新生儿期出现的危险并发症的影响,这些并发症常常导致脑损伤。脑室内-脑实质出血(IVH-IPH)、脑室周围白质软化(PVL)、癫痫、脑膜炎和缺氧缺血性脑病是最常见的并发症。这些问题需要在这个关键时期对脑功能进行更专业的监测。近年来,许多针对极早产儿的研究表明,振幅整合脑电图(aEEG)对短期和长期预后都具有很高的预测价值。事实上,已经证实某些类型的背景活动模式、睡眠-觉醒周期的缺失以及癫痫活动与IVH-IPH和PVL等早期并发症的发生有关。最近的研究表明,在出生后数小时内或出生后的头几天进行的aEEG可以预测早产儿在2岁和3岁时的神经行为发育(贝利量表)。特别是我们的研究表明,aEEG显示的睡眠-觉醒周期丧失,对于患有IVH的早产儿发生出血后脑积水(PPH)具有很高的阳性预测价值;因此,对脑背景活动尤其是睡眠-觉醒周期的研究可以用作PPH风险患者的早期预后工具。