Evaluation of Preoperative Amplitude-Integrated Electroencephalography (aEEG) Monitoring for Predicting Long-Term Neurodevelopmental Outcome Among Infants Undergoing Major Surgery in the Neonatal Period

Bhavesh Mehta; Rodney Hunt; Karen Walker; Nadia Badawi

doi:10.1177/0883073816653781

Evaluation of Preoperative Amplitude-Integrated Electroencephalography (aEEG) Monitoring for Predicting Long-Term Neurodevelopmental Outcome Among Infants Undergoing Major Surgery in the Neonatal Period

J Child Neurol. 2016 Oct;31(11):1276-81. doi: 10.1177/0883073816653781. Epub 2016 Jun 10.

Authors

Bhavesh Mehta¹, Rodney Hunt², Karen Walker³, Nadia Badawi³

Affiliations

¹ Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, Australia Sydney Medical School, University of Sydney, Sydney, NSW, Australia bhavesh.mehta@health.nsw.gov.au.
² Department of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia.
³ Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, Australia Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

PMID: 27287185
DOI: 10.1177/0883073816653781

Abstract

The authors aimed to evaluate preoperative amplitude-integrated electroencephalography (aEEG) patterns for predicting neurodevelopmental outcome among infants undergoing major surgery in the neonatal period. They retrospectively reviewed the preoperative aEEG data of 58 neonates who had undergone major neonatal surgery between 2006 and 2008. The authors classified aEEGs using a weighted background score. Neurodevelopmental outcome was assessed at 3 years of age using the Bayley Scales of Toddler and Infant Development III. Over a third of infants (36%) showed an abnormal aEEG background. Seizure activity was identified in 11 (19%) infants. The majority (68%) of infants had developmental delay, with no significant differences between cardiac and other surgery groups. Logistic regression found no statistically significant but some clinically important associations between aEEG background and neurodevelopmental outcome. Comorbidity was associated with worse outcomes. While the predictive utility of aEEG in this population remains unclear, the findings suggest that further research is warranted.

Keywords: amplitude-integrated electroencephalography; electrical seizure; neonate; neurodevelopmental outcome; surgery.

Publication types

Evaluation Study

MeSH terms

Brain / physiopathology
Child Development
Child, Preschool
Comorbidity
Electroencephalography / methods*
Female
Humans
Infant, Newborn
Logistic Models
Male
Monitoring, Physiologic*
Preoperative Period
Prognosis
Retrospective Studies
Surgical Procedures, Operative*
Treatment Outcome