Mild Hypoxic–Ischemic Encephalopathy: Can Neurophysiological Monitoring Predict Unfavorable Neurological Outcome? A Systematic Review and Meta-analysis

Raffaele Falsaperla; Sarah Sciuto; Daniela Gioè; Laura Sciuto; Francesco Pisani; Piero Pavone; Martino Ruggieri

doi:10.1055/s-0041-1736593

American Journal of Perinatology, Table of Contents

Am J Perinatol 2023; 40(08): 833-838
DOI: 10.1055/s-0041-1736593

Review Article

Mild Hypoxic–Ischemic Encephalopathy: Can Neurophysiological Monitoring Predict Unfavorable Neurological Outcome? A Systematic Review and Meta-analysis

Raffaele Falsaperla

¹Division of Pediatrics and Pediatric Emergency, University Hospital Policlinico “Rodolico-San Marco,” Catania, Italy

²Division of Neonatal Intensive Care and Neonatology, University Hospital Policlinico “Rodolico-San Marco,” Catania, Italy

,

Sarah Sciuto

³Division of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, Pediatrics Postgraduate Residency Program, University of Catania, Catania, Italy

,

Daniela Gioè

⁴Division of Pediatrics, Hospital of Lentini, Lentini, Italy

,

Laura Sciuto

³Division of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, Pediatrics Postgraduate Residency Program, University of Catania, Catania, Italy

,

Francesco Pisani

⁵Division of Pediatrics, University Hospital of Children “Pietro Barilla,” Parma, Italy

,

Piero Pavone

⁶Division of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy

,

Martino Ruggieri

⁶Division of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy

› Author Affiliations

Abstract

Objective Hypoxic–ischemic encephalopathy (HIE) is the second cause of neonatal deaths and one of the main conditions responsible for long-term neurological disability. Contrary to past belief, children with mild HIE can also experience long-term neurological sequelae. The aim of this systematic review is to determine the predictive value of long-term neurological outcome of (electroencephalogram) EEG/amplitude-integrated electroencephalogram (aEEG) in children who complained mild HIE.

Study Design From a first search on PubMed, Google Scholar, and clinicalTrials.gov databases, only five articles were considered suitable for this study review. A statistical meta-analysis with the evaluation of odds ratio was performed on three of these studies.

Results No correlation was found between the characteristics of the electrical activity of the brain obtained through EEG/aEEG in infants with mild HIE and subsequent neurological involvement.

Conclusion EEG/aEEG monitoring in infants with mild HIE cannot be considered a useful tool in predicting their neurodevelopmental outcome, and its use for this purpose is reported as barely reliable.

Key Points

HIE is responsible for long-term neurological outcome, even in newborns with mild HIE.
No correlation was found between EEG/aEEG trace in infants with mild HIE and neurological sequelae.
Neurophysiological monitoring, in mild HIE, cannot predic neurodevelopmental outcome.

Keywords

mild - HIE - newborn - neurophysiological monitoring - neurological outcome

Full Text

References

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