Birca Ala, Lortie Anne, Birca Veronica, Decarie Jean-Claude, Veilleux Annie, Gallagher Anne, Dehaes Mathieu, Lodygensky Gregory A, Carmant Lionel
Division of Neurology, CHU Sainte Justine, Department of Neurosciences and Paediatrics, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada.
Division of Neurology, CHU Sainte Justine, Department of Neurosciences and Paediatrics, University of Montreal, Montreal, Canada.
Clin Neurophysiol. 2016 Apr;127(4):2087-94. doi: 10.1016/j.clinph.2015.12.013. Epub 2015 Dec 18.
To investigate how rewarming impacts the evolution of EEG background in neonates with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).
We recruited a retrospective cohort of 15 consecutive newborns with moderate (9) and severe (6) HIE monitored with a continuous EEG during TH and at least 12h after its end. EEG background was analyzed using conventional visual and quantitative EEG analysis methods including EEG discontinuity, absolute and relative spectral magnitudes. One patient with seizures on rewarming was excluded from analyses.
Visual and quantitative analyses demonstrated significant changes in EEG background from pre- to post-rewarming, characterized by an increased EEG discontinuity, more pronounced in newborns with severe compared to moderate HIE. Neonates with moderate HIE also had an increase in the relative magnitude of slower delta and a decrease in higher frequency theta and alpha waves with rewarming.
Rewarming affects EEG background in HIE newborns undergoing TH, which may represent a transient adaptive response or reflect an evolving brain injury.
EEG background impairment induced by rewarming may represent a biomarker of evolving encephalopathy in HIE newborns undergoing TH and underscores the importance of continuously monitoring the brain health in critically ill neonates.
探讨复温对接受治疗性低温（TH）的缺氧缺血性脑病（HIE）新生儿脑电图（EEG）背景演变的影响。
我们纳入了一个回顾性队列，连续15例中度（9例）和重度（6例）HIE新生儿，在TH期间及结束后至少12小时进行连续EEG监测。使用传统的视觉和定量EEG分析方法分析EEG背景，包括EEG间断性、绝对和相对频谱幅值。一名复温时癫痫发作的患者被排除在分析之外。
视觉和定量分析显示，复温前后EEG背景有显著变化，其特征为EEG间断性增加，重度HIE新生儿比中度HIE新生儿更明显。中度HIE新生儿复温时，较慢的δ波相对幅值增加，较高频率的θ波和α波相对幅值降低。
复温影响接受TH的HIE新生儿的EEG背景，这可能代表一种短暂的适应性反应或反映正在演变的脑损伤。
复温引起的EEG背景损害可能代表接受TH的HIE新生儿脑病演变的生物标志物，并强调了持续监测危重新生儿脑健康的重要性。
