ORIGINAL ARTICLE   

Minerva Pediatrica 2018 December;70(6):539-44

DOI: 10.23736/S0026-4946.17.04792-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Clinical study on amplitude integrated electroencephalogram in cerebral injury caused by severe neonatal hyperbilirubinemia

Hongwei WU, Zhenguang LI ✉, Jinfeng LIU, Gang LIU, Xia YANG

Department of Neonatology, Xuzhou Children’s Hospital, Xuzhou, China

BACKGROUND: This study was designed in order to assess the validity of the use of amplitude-integrated electroencephalogram (aEEG) in cerebral injury caused by severe neonatal hyperbilirubinemia.
METHODS: A total of 56 full-term neonates diagnosed with severe neonatal hyperbilirubinemia and admitted to the NICU of our hospital from July 2013 to December 2014 were continuously selected for the study. The total serum bilirubin (TSB) was higher than 342 μmol/L and was dominated by a higher amount of unconjugated bilirubin. Each patient underwent aEEG monitoring upon admission. And according to the results of the test, they were assigned into an aEEG normal group (N.=38) or an aEEG abnormal group (N.=18). Dynamic monitoring of bilirubin and blood biochemistry was also conducted for all the children after admission. Patients were treated with blue light, anti-infection agents, acidosis correction measures, transfusion exchanges, intravenous drips of albumin or globulin and other specific treatments as needed in each particular case. Brainstem auditory evoked potential (BAEP), MRI examination and a behavioral neurological assessment (NBNA) with 20-item examinations were provided within 4-17 days after admission. Follow-up observations were conducted on growth level (physical development and Gesell scores) at 3, 6, 12 and 18 months.
RESULTS: The results of all the diagnostic tests performed in the patients of both groups all yielded a significantly higher abnormality rate in the aEEG abnormal group compared to the results in the aEEG normal group. Furthermore, the results of follow-up tests showing growth and child development also showed higher abnormality rates in the aEEG abnormal group than in the aEEG normal group.
CONCLUSIONS: Since the results of our aEEG monitoring were consistent with the findings of other diagnostic tests, we proved the convenience and effectivity of aEEG for guiding the treatment and prognosis of severe hyperbilirubinemia in neonates.

KEY WORDS: Electroencephalography - Neonatal hyperbilirubinemia - Brain injuries - Brainstem auditory evoked potentials - Neuropsychological tests - Neurologic examination