Published online February 1, 2005
PEDIATRICS Vol. 115 No. 2 February 2005, pp. 327-332 (doi:10.1542/peds.2004-0863)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (19) Citing Articles via Google Scholar Google Scholar Articles by Osredkar, D. Articles by de Vries, L. S. Search for Related Content PubMed PubMed Citation Articles by Osredkar, D. Articles by de Vries, L. S. Related Collections Neurology & Psychiatry Social Bookmarking                         What's this?

Sleep-Wake Cycling on Amplitude-Integrated Electroencephalography in Term Newborns With Hypoxic-Ischemic Encephalopathy

Damjan Osredkar, MD^*,, Mona C. Toet, MD^*, Linda G. M. van Rooij, MD^*, Alexander C. van Huffelen, MD, PhD, Floris Groenendaal, MD, PhD^* and Linda S. de Vries, MD, PhD^*

^* Departments of Neonatology
Clinical Neurophysiology, Wilhelmina Children's Hospital, Utrecht, Netherlands
Department of Pediatric Neurology, University Children's Hospital, Ljubljana, Slovenia

Objective. The objective of this amplitude-integrated electroencephalography (aEEG) study was to evaluate the influence of perinatal hypoxia-ischemia on sleep-wake cycling (SWC) in term newborns and assess whether characteristics of SWC are of predictive value for neurodevelopmental outcome.

Methods. From a consecutive series of newborns born during a 10-year period, the aEEG tracings of 171 term newborns with hypoxic-ischemic encephalopathy were assessed for the presence, time of onset, and quality of SWC. SWC patterns were categorized with regard to the background pattern on which they presented, as normal or abnormal SWC.

Results. SWC was seen in 95.4% of the surviving newborns and in 8.1% of those who died. The median time intervals from birth to onset of SWC were significantly different in newborns with hypoxic-ischemic encephalopathy grades I, II, and III (7, 33, and 62 hours, respectively). Newborns with seizure discharges developed SWC with a delay of 30.5 hours. Good outcome was associated with earlier onset of SWC and normal SWC pattern. The difference in the median Griffiths' developmental quotients in newborns who started SWC before/after 36 hours was 8.5 points. The good/poor neurodevelopmental outcome was predicted correctly by the onset of SWC before/after 36 hours in 82% of newborns.

Conclusions. The presence, time of onset, and quality of SWC reflected the severity of the hypoxic-ischemic insult to which newborns were exposed. The time of onset of SWC has a predictive value for neurodevelopmental outcome.

---

Key Words: amplitude-integrated electroencephalography • cerebral function monitor • sleep-wake cycles • perinatal hypoxia-ischemia • asphyxia • neonate • prediction • neurodevelopmental outcome

Abbreviations: HIE, hypoxic-ischemic encephalopathy • EEG, electroencephalography • aEEG, amplitude-integrated electroencephalography • SWC, sleep-wake cycling • PPV, positive predictive value • NPV, negative predictive value • BS, burst suppression • CLV, continuous extremely low voltage • FT, flat trace • CNV, continuous normal voltage • DNV, discontinuous normal voltage

---

Accepted Jul 6, 2004.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. M. Murray, G. B. Boylan, C. A. Ryan, and S. Connolly Early EEG Findings in Hypoxic-Ischemic Encephalopathy Predict Outcomes at 2 Years Pediatrics, September 1, 2009; 124(3): e459 - e467. [Abstract] [Full Text] [PDF]

				S. J. Lee, D. P. Hatran, T. Tomimatsu, J. P. Peņa, G. McAuley, and L. D. Longo Fetal cerebral blood flow, electrocorticographic activity, and oxygenation: responses to acute hypoxia J. Physiol., May 1, 2009; 587(9): 2033 - 2047. [Abstract] [Full Text] [PDF]

				V. Y. Chock and A. S. Davis Bedside Cerebral Monitoring to Predict Neurodevelopmental Outcomes NeoReviews, March 1, 2009; 10(3): e121 - e129. [Abstract] [Full Text] [PDF]

				V. M. Pulgar, J. Zhang, G. A. Massmann, and J. P. Figueroa Prolonged Mild Hypoxia Alters Fetal Sheep Electrocorticogram Activity Reproductive Sciences, September 1, 2006; 13(6): 404 - 411. [Abstract] [PDF]

				L. Hellstrom-Westas, I. Rosen, L.S. de Vries, and G. Greisen Amplitude-integrated EEG Classification and Interpretation in Preterm and Term Infants NeoReviews, February 1, 2006; 7(2): e76 - e87. [Full Text] [PDF]

				C. Amiel-Tison, J. Gosselin, and S. Gahagan Why Is the Neurological Examination So Badly Neglected in Early Childhood? Pediatrics, October 1, 2005; 116(4): 1047 - 1047. [Full Text] [PDF]

				D. Osredkar, I.-L. van Haastert, and L. S. de Vries Why Is the Neurological Examination So Badly Neglected in Early Childhood?: In Reply Pediatrics, October 1, 2005; 116(4): 1048 - 1048. [Full Text] [PDF]

				L S de Vries and L Hellstrom-Westas Role of cerebral function monitoring in the newborn Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2005; 90(3): F201 - f207. [Abstract] [Full Text] [PDF]