Dados do Trabalho

Título

COULD PRETERM INFANTS BENEFIT FROM NEUROMONITORING WITH VIDEO AEEG/EEG?

Introdução

More than 80% of neonatal seizures are completely subclinical and represent a risk factor for neurodevelopmental delays in preterm infants. Amplitude integrated electroencephalography combined with raw electroencephalography and video images (video aEEG/EEG) provides real-time monitoring for seizure detection.

Objetivo

To analyze the incidence, pattern and treatment of seizures verified on video aEEG/EEG in preterm infants.

Métodos

Retrospective cohort study carried out from June 2017 to June 2021, including preterm infants with gestational age <32 weeks monitored with video aEEG/EEG for at least 24 hours in the first seven days of life. Data was collected by medical records and database review of monitored infants in 39 hospitals in Brazil. Demographic and clinical data were correlated with video aEEG/EEG findings. Descriptive analysis was performed using absolute and relative frequencies, and nonparametric variables were presented as median and interquartile ranges (IQR).

Resultados

392 preterm infants were included, 55.8% male and 68,9% born by C-section. The median birth weight was 1060 (815-1325) grams, and for gestational age, 29 (27-30) weeks. The median of the monitoring time was 68.9 (47.7-91.0) hours. 102 (26.0%) newborns presented seizures, 67 (65.7%) repetitive. 89 (87.2%) seizures were subclinical, and 59 (57.8%) were identified in the first 24 hours of monitoring. Pathological background activity pattern was present in 82 (80.4%) newborns that had seizures and 94 (32.4%) of those without seizures (p<0,0001). Newborns <28 weeks had a higher percentage of 60.3% pathological background activity pattern and 30.5% presence of seizures. Very low-weight preterm newborns had a higher percentage of pathological patterns, 59.3%, and the presence of seizures, 32.9%. 96 (94.1%) newborns that presented seizures received antiepileptic drugs. Phenobarbital was the first line treatment in 100% of the cases, and in 59 (60.8%) cases was sufficient for total seizure control.

Conclusões

Given the high incidence of subclinical seizures in preterm infants, monitoring with video aEEG/EEG is essential for seizure diagnosis and management, as well as for the feasibility of the intervention in real-time.

Palavras chave

Preterm infant, neuromonitoring, electroencephalography, neonatal seizures, amplitude-integrated electroencephalography.

Referências (se houver)

Shah DK, Zempel J, Barton T, Lukas K, Inder TE. Electrographic seizures in preterm infants during the first week of life are associated with cerebral injury. Pediatr Res. 2010;67:102–6.
Vesoulis ZA, Inder TE, Woodward LJ, et al. Early electro- graphic seizures, brain injury, and neurode- velopmental risk in the very preterm infant. Pediatr Res. 2014 Apr;75(4):564–9.
Shah PS, Lui K, Sjors G, Mirea L, Reichman B, Adams M, et al. Neonatal outcomes of very low birth weight and very preterm neonates: an international comparison. J. Pediatr. 2016;177:144–52. doi: 10.1016/j.jpeds.2016.04.083.

Declaração de conflito de interesses de TODOS os autores

Pietrobom, RFR declara não haver conflito de interesses.
Llaguno, NS declara não haver conflito de interesses.
Rodrigues, DP declara não haver conflito de interesses.
Magalhães, M declara não haver conflito de interesses.
Variane, GFT declara não haver conflito de interesses.
Girotto, PN declara não haver conflito de interesses.
Sampaio LPB declara não haver conflito de interesses.