Rawad Obeid1, Yoshimi Sogawa2, Satyanarayana Gedela3, Monica Naik3, Vince Lee4, Richard Telesco5, Jessica Wisnowski6, Christine Magill3, Michael J Painter3, Ashok Panigrahy4. 1. Department of Neurology, Children's National Health System, Washington, District of Columbia. Electronic address: rawad.obeid@hotmail.com. 2. Division of Pediatric Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: yoshimi.sogawa@chp.edu. 3. Division of Pediatric Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania. 4. Division of Pediatric Radiology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania. 5. Division of Newborn Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania. 6. Department of Radiology, Children's Hospital of Los Angeles, Los Angeles, California.
Abstract
OBJECTIVE: Electroencephalograph recorded in the first day of life in newborns treated with hypothermia for hypoxic-ischemic encephalopathy could be utilized as a predictive tool for the severity of brain injury on magnetic resonance imaging and mortality. STUDY DESIGN: We analyzed newborns who were admitted for therapeutic hypothermia due to hypoxic-ischemic encephalopathy. All enrolled infants underwent encephalography within the first 24 hours of life and underwent brain magnetic resonance imaging after rewarming. All encephalographs were independently reviewed for background amplitude, continuity, and variability. Brain injury determined by magnetic resonance imaging was scored using methods described by Bonifacio et al. RESULTS: Forty-one newborns were included in the study. Each encephalograph variable correlated significantly with the severity of injury on brain magnetic resonance imaging (P < 0.001 for each). The overall encephalograph severity estimated as mild, moderate, and severe also correlated with injury (P < 0.001). Each encephalograph variable correlated with mortality (P < 0.001 for each) and also the overall encephalograph severity (P < 0.001). CONCLUSION: Severity of electrographic findings on encephalograph in the first day of life during therapeutic hypothermia for hypoxic-ischemic encephalopathy correlated with the extent of injury on brain magnetic resonance imaging. This information may be useful for families and aid guide clinical decision making.
OBJECTIVE: Electroencephalograph recorded in the first day of life in newborns treated with hypothermia for hypoxic-ischemicencephalopathy could be utilized as a predictive tool for the severity of brain injury on magnetic resonance imaging and mortality. STUDY DESIGN: We analyzed newborns who were admitted for therapeutic hypothermia due to hypoxic-ischemicencephalopathy. All enrolled infants underwent encephalography within the first 24 hours of life and underwent brain magnetic resonance imaging after rewarming. All encephalographs were independently reviewed for background amplitude, continuity, and variability. Brain injury determined by magnetic resonance imaging was scored using methods described by Bonifacio et al. RESULTS: Forty-one newborns were included in the study. Each encephalograph variable correlated significantly with the severity of injury on brain magnetic resonance imaging (P < 0.001 for each). The overall encephalograph severity estimated as mild, moderate, and severe also correlated with injury (P < 0.001). Each encephalograph variable correlated with mortality (P < 0.001 for each) and also the overall encephalograph severity (P < 0.001). CONCLUSION: Severity of electrographic findings on encephalograph in the first day of life during therapeutic hypothermia for hypoxic-ischemicencephalopathy correlated with the extent of injury on brain magnetic resonance imaging. This information may be useful for families and aid guide clinical decision making.