aEEG Assessment for Short-Term Outcome Prognosis Prediction in Hypoxic-Ischemic Encephalopathy: An 11-Year Experience.

Abstract

Objectives: Hypoxic-ischemic encephalopathy (HIE) continues to be a predominant cause of morbidity and mortality in neonates. Therapeutic hypothermia (TH) is the only method with proven neuroprotective effects, and the aim of this study was to evaluate the short-term results of patients treated with TH.

Methods: Demographic, clinical characteristics, laboratory and aEEG results of patients who received TH treatment with a diagnosis of Stage II or Stage III HIE according to modified Sarnat staging in the Neonatal Intensive Care Unit were analyzed retrospectively.

Results: A total of 101 patients were included in the study. The mean gestational age of the patients was 38.8±1.5 weeks, the mean birth weight was 3215±499.5 g, and 40.6% were female. According to the modified Sarnat staging, 50.5% of the patients were evaluated as Stage II, and the others as Stage III HIE. The most common peripartum risk factors were meconium delivery (25.7%) and prolonged or difficult labor (20.7%). Mortality rates in patients with Stage II and Stage III HIE were 5.9% and 26%, respectively. In one of the patients who died, the 6th-hour aEEG background activity was moderately abnormal, and in 15 patients there was a severely abnormal voltage pattern. Acute kidney injury was found to be the most effective factor in mortality.

Conclusion: In our study, it was concluded that the mortality rate of newborns diagnosed with Stage III HIE was higher, the biggest impact factor on mortality was acute kidney injury, and 6th-hour voltage activity in aEEG monitoring was useful in predicting prognosis.