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Abstract：
Background The characteristics of amplitude-integrated electroencephalography (aEEG) are associated with neurological outcomes in neonates with hypoxic-ischemic encephalopathy (HIE). We perform a longitudinal analysis of continuous monitoring of aEEG during therapeutic hypothermia and explore the association between aEEG interpretation and clinical neurological outcomes. Method We conducted a prospective cohort study on HIE neonates undergoing hypothermia with aEEG monitoring. Results A total of 37 HIE infants underwent hypothermia with improved aEEG background activity in 28 (75.7%) neonates, of which 18 (48.6%) neonates had background activity returned to a continuous pattern, and the median recovery time was 26.5 hours. Sleep-wake cycle (SWC) appeared in 14 (37.8%) cases, with a median onset time of 34.5 hours. Seizure activity on aEEG was present in 26 (70.3%) infants. Factors associated with poor outcomes at discharge included low voltage or flat trace background activity, a lack of improvement in background activity after hypothermia, and the absence of SWC. Neonates who took longer than 62 hours to return to continuous background activity (time to normal trace) or did not have SWC before the end of hypothermia were more likely to have unfavorable outcomes at discharge. Conclusions Longitudinal analysis of aEEG during hypothermia should be implemented in neonatal care units. The progression of these features on aEEG may predict neurological outcomes for HIE neonates.
摘要：
背景：振幅整合脑电图（aEEG）的特征与新生儿缺氧缺血性脑病（HIE）的神经系统预后相关。我们对治疗性低温期间aEEG的连续监测进行纵向分析，并探讨aEEG解释与临床神经系统结局之间的关联。方法我们在aEEG监测下对接受低温治疗的HIE新生儿进行了前瞻性队列研究。结果37例HIE患儿中28例(75.7%)进行了低体温和aEEG背景活动改善,其中18名(48.6%)新生儿背景活动恢复到连续模式，中位恢复时间为26.5小时。14例(37.8%)出现睡眠-觉醒周期(SWC),中位起效时间为34.5小时。26例（70.3％）婴儿的aEEG癫痫发作活动。与放电不良结果相关的因素包括低电压或平坦迹线背景活动，低温后背景活动缺乏改善，没有SWC。在低温结束之前需要超过62小时才能恢复到连续背景活动（达到正常追踪的时间）或没有SWC的新生儿在出院时更有可能出现不利结果。结论新生儿监护病房应在低体温期间实施aEEG的纵向分析。aEEG上这些特征的进展可以预测HIE新生儿的神经系统结局。
