Predictive value of neonatal electroencephalograms before and during extracorporeal membrane oxygenation

Leonard J. Graziani, Leopold Streletz, Stephen Baumgart, James Cullen, Linda M. McKee

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

We studied the prognostic significance of electroencephalograms recorded serially at 2- to 4-day intervals during the acute neonatal course of 119 near-term infants with severe respiratory failure treated by venoarterial extracorporeal membrane oxygenation (ECMO). A poor prognosis was defined as early death (n = 27), an abnormally low developmental assessment score (n = 14), or cerebral palsy (n = 14) at 12 to 45 months of age. The only electroencephalographic abnormalities that were significantly related to a poor prognosis were burst suppression (B-S) and electrographic seizure (ES). The 30 infants with two or more recordings of B-S or ES, when compared with the 58 neonates without such electroencephalographic abnormalities, had an odds ratio for a poor prognosis of 6.6 (95% confidence limits, 2.2 to 20.2). The 31 infants with a single ES or B-S recording did not have a significantly increased risk for a poor prognosis. Cardiopulmonary resuscitation immediately before ECMO (n = 8) and the lowest systolic blood pressure before or during ECMO were significantly related to the occurrence of ES or B-S recordings. There was no significant predilection of ES for either cerebral hemisphere. We conclude that in near-term neonates with respiratory failure, serial electroencephalographic recordings are of predictive value, and may facilitate clinical care including the decision to initiate or to continue ECMO. (J PEDIATR 1994;125:969-75).

Original languageEnglish
Pages (from-to)969-975
Number of pages7
JournalThe Journal of Pediatrics
Volume125
Issue number6 PART 1
DOIs
Publication statusPublished - 1994
Externally publishedYes

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Extracorporeal Membrane Oxygenation
Electroencephalography
Seizures
Respiratory Insufficiency
Newborn Infant
Cardiopulmonary Resuscitation
Cerebrum
Cerebral Palsy
Hypotension
Epilepsy
Odds Ratio
Blood Pressure

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Predictive value of neonatal electroencephalograms before and during extracorporeal membrane oxygenation. / Graziani, Leonard J.; Streletz, Leopold; Baumgart, Stephen; Cullen, James; McKee, Linda M.

In: The Journal of Pediatrics, Vol. 125, No. 6 PART 1, 1994, p. 969-975.

Research output: Contribution to journalArticle

Graziani, Leonard J. ; Streletz, Leopold ; Baumgart, Stephen ; Cullen, James ; McKee, Linda M. / Predictive value of neonatal electroencephalograms before and during extracorporeal membrane oxygenation. In: The Journal of Pediatrics. 1994 ; Vol. 125, No. 6 PART 1. pp. 969-975.
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