The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis

doi:10.1111/j.1651-2227.2009.01567.x

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Wiley InterScience

Acta Pædiatrica

Volume 99 Issue 2, Pages 194 - 200

Published Online: 4 Nov 2009

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REGULAR ARTICLE

The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis

HJ ter Horst, M van Olffen, HJ Remmelts, H de Vries, AF Bos

Division of Neonatology, Department of Pediatrics, University Medical Center Groningen, The Netherlands

Correspondence to H J ter Horst, Department of Pediatrics, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands.
Tel: +31 50 3614215 |
Fax: +31 50 3614235 |
Email: h.j.ter.horst@bkk.umcg.nl

KEYWORDS

Cerebral function monitor • Electroencephalogram • Infant • Meningitis

ABSTRACT

Aim: To investigate the longitudinal course and prognostic value of amplitude integrated EEG (aEEG) in infants with neonatal sepsis or meningitis.

Methods: Amplitude integrated EEG recordings of 22 infants with sepsis/meningitis were retrospectively evaluated. Mean gestational age was 38 weeks (range: 34–42 weeks). Thirteen infants had meningitis. Survivors were seen for neurological follow-up. Four infants died, two were severely abnormal at 24 months. Amplitude integrated EEG background pattern, sleep wake cycling (SWC) and electrographic seizure activity (EA) were appraised.

Results: All infants with continuous low voltage or flat trace on aEEG (n = 4) had an adverse outcome. Low voltage aEEGs (n = 9) had a positive LR (LR+) for an adverse outcome of 5.3 (95% CI: 1.9–14.8) at 6 h and 8.3 (95% CI: 1.3–55) at 24 h after admission. EA was more frequent in infants with adverse outcome (p < 0.01) and had a LR+ for adverse outcome of 10.6 (95% CI: 1.5–76). SWC appeared more frequent in infants with good outcome (p < 0.05).

Conclusion: Low voltage background pattern, SWC and EA on aEEG are helpful to predict neurological outcome in infants with neonatal sepsis or meningitis.

Received 30 June 2009; revised 30 September 2009; accepted 1 October 2009.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1651-2227.2009.01567.x About DOI