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Clinical biological and electroencephalographic monitoring of newborns with neurological risk in the Neonatal Intensive Care Unit

机译:新生儿重症监护单位新生儿的新生儿临床生物学和脑电图监测

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摘要

Newborns admitted to the Neonatal Intensive Care Unit (NICU) require increased attention regarding neurological assessment and monitoring, due to immaturity or certain conditions that occur during the perinatal and neonatal period. Hypoxic-ischemic encephalopathy (HIE) following perinatal asphyxia is one of the most studied clinical conditions due to the risk of medium- and long-term neurobehavioral outcome. We studied 43 newborns with HIE, for all 3 degrees of impairment, performed amplitude-integrated electroencephalography (aEEG) in the first hours of life and collected common laboratory tests, following serum glycemia at admission and creatinine, creatine kinase (CK) and lactate dehydrogenase (LDH) at admission and in the 3rd day of life. Newborns with mild HIE presented normal aEEG pattern and slightly elevated CK. A total of 80.9% of the newborns with moderate HIE had seizure patterns in aEEG, while among those with severe HIE, 71.4% had seizure patterns in aEEG and 28.5% burst suppression. CK and LDH were mean elevated in those with moderate HIE, and the newborns with severe HIE had also high creatinine values at admission and in the 3rd day of life. Statistically significant differences between the 3 degrees of HIE were noted in terms of creatinine (P=0.009) and CK (P=0.008) at admission and LDH in the 3rd day of life (P=0.036). Hypoglycemia was common in our study group. In conclusion, common blood tests in association with aEEG monitoring and rigorous neurological assessment can predict short-term outcome of HIE and multiorgan dysfunction and can help clinicians predict even long-term outcomes in severe HIE.
机译:进入新生儿重症监护病房(NICU)的新生儿需要增加神经系统评估和监测的注意力,因为在围产期和新生儿期间发生的某些情况发生。由于中期和长期神经病成果的风险,围产期窒息之后的缺氧缺血性脑病(HIE)是最受研究的临床条件之一。我们研究了43名与HIE的新生儿,对于所有3个损伤,在寿命的第一小时内进行幅度整合的脑电图(AEEG),并在入院和肌酐,肌酸激酶(CK)和乳酸脱氢酶上进行血清糖血症术后常见的实验室测试(LDH)入场,在生命的第3天。新生儿与轻度HIE呈现正常的AEEG模式,略微升高。共有80.9%的新生儿具有中度HIE的癫痫发作模式,而具有严重HIE的人,71.4%在AEEG中癫痫发作模式和28.5%的突发抑制。 CK和LDH的平均值在中等HIE中升高,并且具有严重HIE的新生儿在入场时也具有高肌酸酐价值和在生命的第3天。在第3天生命中的肌酐(P = 0.009)和CK(p = 0.008)方面,在寿命中的入院和LDH方面,注意到了3度HIE之间的统计学差异(P = 0.036)。低血糖在我们的研究组中很常见。总之,与AEEG监测和严谨神经系统评估相关的常见血液检验可以预测HIE和多功能功能障碍的短期结果,可以帮助临床医生预测严重HIE的长期结果。

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