The Application Of Amplitude Integrated EEG In Neonates With Brain Injury Because Of Asphyxia

ObjectiveThe arm to recording50amplitude integrated EEG of brain injury of asphyxiated innewborns after birth in6h,5d and10d. while utilization body movement quality toassess the development of the nervous system behavior with follow-up of6months ofage, investigate the value of aEEG early diagnosis of asphyxia neonatal brain injuryvalue of monitoring time relationship and assess prognosis.The purpose of provide thebasis for guiding treatment and early intervention to explore new methods for theclinical prognosis of brain injury in the early diagnosis and evaluation of neonates withasphyxia.MethodA prospective study method, the Third Affiliated Hospital of Anhui Medical Universityfrom March2010to September pediatric neonatal ward admitted50asphyxiatednewborns (neonates with asphyxia diagnosis to the American Academy of Pediatrics(AAP) and Obstetrics and Gynecology Society(ACOG) to develop standards for thegold standard).50asphyxiated newborns dynamic aEEG monitoring within6h afterbirth for at least5days,10days each record once aEEG. Using the EEG monitorrecords aEEG produced by Natual, each the aEEG recording time are1-2h, electrodeplaced in the bilateral parietal bone and the Central District(Biparietal bone and centralareas of the electrode position, respectively, representing a10/20international placedelectrode position P3, P4, and C3, C4).3days after birth by cranial MRI examination in all subjects.Analysis6h after birth the different performance of aEEG,varying degrees MRI with acorresponding degree of asphyxia neonatal sensitivity and specificity.Select the sameperiod, within6hours aEEG monitoring display are normal full-term newborns20casesof the control group, obstetric born from the Third Affiliated Hospital of Anhui MedicalUniversity，boys, girls10cases each group. In gestational age, sex, height, weight,and other aspects of the Control group no significant differences. All subjects check ofneuropsychological development in outpatient after6months birth (Capital Institute ofPediatrics developed0-6years child psychology mental scale. The questionnaireincludes five aspects; gross motor, fine motor, adaptive capacity, language and socialskills to the test results <70is divided into short neuropsychological development oflow,70-85,85-114low normal,114-130smart,85-130normal,130points or more foroutstanding Supreme line). Smart developmental assessment, analysis of the childrenwith recent neurobehavioral development and after birth within6h aEEG.Compare afterbirth5days,10days with varying degrees aEEG asphyxiated newborn the recentnervous system prognosis.Results50patients participated in the study in neonates with asphyxia,light, severe asphyxiawere23,27cases.37cases of abnormal, abnormal rate of74%; mildly abnormal in21cases including16cases of severe abnormalities with the6h after birth Aeeg.12casesof pure amplitude pop band boundary anomalies,10patients with paroxysmal epilepticdischarge,15patients without paroxysmal discharge. aEEG monitoring results Within6h predicted light suffocation, severe sensitivity and specificity of78.57%,56.52%.6hafter birth,5d,10d, respectively, monitoring children with aEEG results show that, withthe monitoring time after the shift, aEEG predicted asphyxia brain damage decreasedsensitivity, specificity increased.6h after birth,5d,10d, respectively, monitoringchildren with aEEG results show that, with the monitoring time after the shift, aEEG predicted asphyxia brain damage decreased sensitivity, specificity increased.6hmonitored within the highest sensitivity,10d highest specificity monitoring.50cases ofneonatal MRI, abnormal30cases (60%),MRI and aEEG the consistency of74.00%.The twist movement stage abnormal2cases,20cases in the control group restlessmovement stage1cases of abnormal.6-month-old the line Child Neurology heartdevelopment testing,50cases of children <70points2, aEEG are severe abnormalities,MRI abnormalities.70-85points in four cases;85-114points with41cases;114-130points three cases.20cases in the control group15cases70-85points in1,85-114,114-130four cases.Conclusion1. Within6h after birth aEEG better diagnostic value of early brain injury in neonateswith asphyxia, recent nervous system development.2. With the rear of the monitor time shift, aEEG decreased sensitivity to predictasphyxia brain damage, specificity elevation. Monitoring sooner sensitivity of thehigher, the highest sensitivity within6h.3. Good predictor of early aEEG monitoring of neonates with asphyxia recentneuropsychological development.