Kontakt 2008, 10(2):435-441 | DOI: 10.32725/kont.2008.064

Importance of monitoring the brain activity in newborns with early onset asphyxial syndromeHealth and Social Sciences

Jana Lukášková¹, Zdeňka Tomšíková^2,3,*, Zdeněk Kokštein¹

¹ Fakultní nemocnice v Hradci Králové, Dětská klinika

² Nemocnice České Budějovice, a. s., Neonatologické oddělení

³ Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, katedra klinických oborů

In our work, we considered foreign studies, which supported the importance of the aEEG in the early prediction of the neurological development in newborns with early onset asphyxial syndrome. The target of the work was to support a correlation between the type of the aEEG curve and degree of involvement in newborns over the first hours after the hypoxic insult and to introduce this approach into routine practice.

Method: In 56 newborns, who experienced perinatal hypoxia (average umbilical pH 6.95, average BE - 17.3) and in two newborns after early onset postnatal hypoxia, the aEEG record was continuously monitored. During the evaluation of the aEEG records, the basic activity according to classification by Hellström-Westas was followed. The degree of the hypoxic-ischaemic encephalopathy was evaluated according to the classification by Sarnat-Sarnat. The present work does not include evaluation of a further neurological development.

Results: In 12 (21%) of 56 newborns, there was no development of HIE, 8 (14%) had HIE of degree I, 19 (35%) had HIE of degree II and 17 (30%) had HIE of degree III. Newborns without the development of HIE had normal or slightly abnormal curves. In children with HIE of degree I, we recorded normal or slightly abnormal curves. In children with development of HIE of degree II, we encountered all the types of curves from normal to severely pathological ones. In the group with HIE of degree III, all the children exerted pathological curves of the type "discharge-flattening", low-voltage or flat curve. The results suggest that if the child has a pathological curve over the first hours, then HIE of at least degree II was developed. 53% of children with flat curve encountered HIE of degree III.

Conclusion: Cerebral function monitoring is a non-invasive method suitable for early assessment of the severity of the experienced perinatal hypoxia. Given the possibility of the evaluation as soon as over the first hours of the life, this should be a suitable approach to the screening of patients for therapeutic hypothermia.

Keywords: Newborn; Hypoxic-ischaemic encephalopathy; Cerebral function monitor; aEEG; Neurological development

Received: September 5, 2008; Accepted: September 15, 2008; Prepublished online: December 17, 2008; Published: December 17, 2009  Show citation