Clinical Neurophysiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Italy.
Child and Adolescent Neuropsychiatry Unit - A.S.S.T Rhodense, Rho, Milan, Italy.
Clin Neurophysiol. 2021 Apr;132(4):886-903. doi: 10.1016/j.clinph.2021.01.012. Epub 2021 Feb 3.
The aim of this work is to establish inclusive guidelines on electroencephalography (EEG) applicable to all neonatal intensive care units (NICUs). Guidelines on ideal EEG monitoring for neonates are available, but there are significant barriers to their implementation in many centres around the world. These include barriers due to limited resources regarding the availability of equipment and technical and interpretive round-the-clock personnel. On the other hand, despite its limitations, amplitude-integrated EEG (aEEG) (previously called Cerebral Function Monitor [CFM]) is a common alternative used in NICUs. The Italian Neonatal Seizure Collaborative Network (INNESCO), working with all national scientific societies interested in the field of neonatal clinical neurophysiology, performed a systematic literature review and promoted interdisciplinary discussions among experts (neonatologists, paediatric neurologists, neurophysiologists, technicians) between 2017 and 2020 with the aim of elaborating shared recommendations. A consensus statement on videoEEG (vEEG) and aEEG for the principal neonatal indications was established. The authors propose a flexible frame of recommendations based on the complementary use of vEEG and aEEG applicable to the various neonatal units with different levels of complexity according to local resources and specific patient features. Suggestions for promoting cooperation between neonatologists, paediatric neurologists, and neurophysiologists, organisational restructuring, and teleneurophysiology implementation are provided.
本研究旨在制定适用于所有新生儿重症监护病房（NICU）的脑电图（EEG）通用指南。目前已有关于新生儿理想 EEG 监测的指南，但在世界许多中心，这些指南的实施存在重大障碍。这些障碍包括由于设备和技术及解读人员的可用性等资源有限造成的障碍。另一方面，尽管振幅整合脑电图（aEEG）（以前称为脑功能监测仪[CFM]）存在局限性，但它是 NICU 中常用的替代方法。意大利新生儿癫痫协作网络（INNESCO）与所有对新生儿临床神经生理学领域感兴趣的国家科学学会合作，在 2017 年至 2020 年期间进行了系统的文献回顾，并促进了专家（新生儿科医生、儿科神经科医生、神经生理学家、技术人员）之间的跨学科讨论，旨在制定共识建议。已就视频脑电图（vEEG）和 aEEG 达成主要新生儿适应证的共识声明。作者根据 vEEG 和 aEEG 的互补使用提出了一个灵活的建议框架，适用于根据当地资源和特定患者特征具有不同复杂程度的各种新生儿病房。还提供了促进新生儿科医生、儿科神经科医生和神经生理学家之间合作、组织重构和远程神经生理学实施的建议。
