Amplitude integrated EEG 3 and 6 hours after birth in full term neonates with hypoxic-ischaemic encephalopathy

Aim-To assess the prognostic value of amplitude integrated EEG (aEEG) 3 and 6 hours after birth. Methods-Seventy three term, asphyxiated infants were studied (from two diff erent centres), using the Cerebral Function Monitor (CFM Lectromed). The di fferent aEEG tracings were compared using pattern recognition (flat tracing mainly isoelectric (FT); continuous extremely low voltage (CFM); burst-sup pression (BS); discontinuous normal voltage (DMI); continuous normal voltag e (CNV)) with subsequent outcome. Results-Sixty eight infants were followed up for more than 12 months (range 12 months to 6 years). Twenty one out of 68 infants (31%) showed a change in pattern from 3 to 6 hours, but this was only significant in five cases ( 24%). in three this changed from BS to CNV with a normal outcome. One infan t showed a change in pattern from CNV to FT and had a major handicap at fol low up. Another infant showed a change in pattern from DNV to BS, and devel oped a major handicap at follow up. The other 16 infants did not have any s ignificant changes in pattern: 11 infants had CLV, BS, or FT at 3 and 6 hou rs and died (n = 9) in the neonatal period or developed a major handicap (n = 2). Five infants had a CNV or DNV pattern at 3 and 6 hours, with a norma l outcome. The sensitivity and specificity of BS, together with FT and CLV, for poor outcome at 3 hours was 0.85 and 0.77, respectively; at 6 hours 0. 91 and 0.86, respectively. The positive predictive value (PPV) was 78% and the negative predictive value (NPV) 84% 3 hours after birth. At 6 hours the PPV was 86% and the NPV was 91%. Conclusion-aEEG could be very useful for selecting those infants who might benefit from intervention after birth asphyxia.