Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia

Yun-Ju Chen; Ming-Chou Chiang; Jainn-Jim Lin; I-Jun Chou; Yi-Shan Wang; Shu-Sing Kong; I-Chen Su; Elaine Chen; Tze Yee Diane Mok; Reyin Lien; Kuang-Lin Lin

Biomedical Journal (Jun 2020)

Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia

Yun-Ju Chen,
Ming-Chou Chiang,
Jainn-Jim Lin,
I-Jun Chou,
Yi-Shan Wang,
Shu-Sing Kong,
I-Chen Su,
Elaine Chen,
Tze Yee Diane Mok,
Reyin Lien,
Kuang-Lin Lin

Affiliations

Yun-Ju Chen: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Ming-Chou Chiang: Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Division of Neonatology, Department of Pediatrics, Chang Gung Children's at Linkou, 5, Fusing St., Gueishan, Taoyuan 333, Taiwan.
Jainn-Jim Lin: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Children's at Linkou, 5, Fusing St., Gueishan, Taoyuan 333, Taiwan.
I-Jun Chou: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Yi-Shan Wang: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Shu-Sing Kong: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
I-Chen Su: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Elaine Chen: Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Tze Yee Diane Mok: Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Reyin Lien: Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
Kuang-Lin Lin: Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan

Journal volume & issue: Vol. 43, no. 3
pp. 285 – 292

Abstract

Read online

Background: The aim of this study was to examine the predictive value of amplitude-integrated electroencephalography (aEEG) on 12-month seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia. Methods: We conducted this retrospective cohort study in a tertiary neonatal intensive care unit between May 2012 and September 2017. Neonates with HIE who received both therapeutic hypothermia (TH) and aEEG were enrolled. Results: A total of 23 infants (14 boys, nine girls) with a mean gestational age of 38.9 weeks were enrolled. Fifteen (65%) infants had moderate HIE and eight (35%) had severe HIE according to modified Sarnat staging. The mean aEEG recording time was 107.5 h. Twenty (86.9%) infants had seizure activity during the first 24 h after cooling and 14 (60.8%) had seizure activity during the first 24 h after rewarming. At 12 months, five (21.7%) infants had poor seizure outcomes. Repetitive seizures or status epilepticus pattern during the first 24 h after rewarming, but not the first 24 h after cooling, were associated with the presence of epilepsy at 12 months (p = 0.037). Conclusions: We identified a high incidence of electrographic seizures in infants with neonatal HIE treated with therapeutic hypothermia, and post-neonatal epilepsy in the children who survived after HIE. Repetitive seizures or status epilepticus pattern during the first 24 h after rewarming, but not in the first 24 h after cooling, were associated with the presence of epilepsy at 12 months.

Published in Biomedical Journal

ISSN: 2319-4170 (Print); 2320-2890 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General); Science: Biology (General)
Website: https://www.sciencedirect.com/journal/biomedical-journal

About the journal

Abstract

Keywords