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振幅整合脑电图对脓毒症相关性脑病新生儿不良结局的预测能力:一项队列研究

Predictive Ability of Amplitude Integrated Electroencephalography for Adverse Outcomes in Neonates with Sepsis-Associated Encephalopathy: A Cohort Study.

作者信息

Jain Priyansh, Saini Shiv Sajan, Sahu Jitendra Kumar, Madaan Priyanka, Sundaram Venkataseshan, Dutta Sourabh

机构信息

Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Division of Neonatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

出版信息

Indian J Pediatr. 2025 Jan;92(1):73-75. doi: 10.1007/s12098-024-05098-x. Epub 2024 Mar 22.

Abstract

The authors examined the prevalence of abnormal amplitude integrated electroencephalography (aEEG) patterns in neonates diagnosed with sepsis-associated encephalopathy (SAE). They recorded 36626 min of aEEG in 75 study neonates. Encephalopathy was defined by the Brighton Collaboration Neonatal Encephalopathy criteria. Neonates with primary outcome [either non-survivors or survivors with abnormal neurological examination at discharge using Amiel-Tison assessment tool, n = 58, (77%)] were compared with 17 survivors having normal neurological examination at discharge. Severely abnormal aEEG patterns (isoelectric voltage, continuous low voltage, burst suppression) collectively represented 31% of total 36626 min aEEG tracings. Neonates experiencing primary outcome had significantly higher Burdjalov scores than survivors with normal neurological exam (p value 0.01). After adjusting for gestational age, birth weight, and invasive ventilation, severely abnormal aEEG (aOR 5.8, 95% CI 1.7-19.5, p value 0.005) and Burdjalov score (aOR 0.77, 95% CI 0.63-0.95, p value 0.01) were independently associated with death or abnormal neurological examination at discharge.

摘要

作者研究了被诊断为脓毒症相关性脑病(SAE)的新生儿中异常振幅整合脑电图(aEEG)模式的患病率。他们记录了75名研究新生儿36626分钟的aEEG。脑病由布莱顿协作组新生儿脑病标准定义。将有主要结局的新生儿[非存活者或出院时使用阿米尔 - 蒂森评估工具进行神经系统检查异常的存活者,n = 58,(77%)]与17名出院时神经系统检查正常的存活者进行比较。严重异常的aEEG模式(等电位电压、持续低电压、爆发抑制)在总共36626分钟的aEEG记录中占31%。经历主要结局的新生儿的布尔贾洛夫评分显著高于神经系统检查正常的存活者(p值0.01)。在调整胎龄、出生体重和有创通气后,严重异常的aEEG(调整后比值比5.8,95%置信区间1.7 - 19.5,p值0.005)和布尔贾洛夫评分(调整后比值比0.77,95%置信区间0.63 - 0.95,p值0.01)与出院时死亡或神经系统检查异常独立相关。

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