Newborns at high risk for brain injury: the role of the amplitude-integrated electroencephalography

• Published in: Jornal de pediatria Vol. 98; no. 6; pp. 565 - 571
• Main Authors: Variane, Gabriel Fernando Todeschi, Rodrigues, Daniela Pereira, Pietrobom, Rafaela Fabri Rodrigues, França, Carolina Nunes, Netto, Alexandre, Magalhães, Maurício
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Elsevier Editora Ltda 01.11.2022; Elsevier; Sociedade Brasileira de Pediatria
• Subjects: aEEG; Amplitude-integrated electroencephalography; Brain injuries; Brain Injuries - diagnosis; Brain monitoring; Critical Illness; Electroencephalography; Humans; Infant; Infant, Newborn; Infant, Premature; Neonatal intensive care units; Newborns; PEDIATRICS; Review; Seizures - diagnosis; Seizures - etiology; Newborns; Amplitude-integrated electroencephalography; aEEG; Neonatal intensive care units; Brain monitoring; Brain injuries
• ISSN: 0021-7557; 1678-4782; 1678-4782
• DOI: 10.1016/j.jped.2021.10.008

Amplitude-integrated electroencephalography (aEEG) is a simplified bedside neurophysiology tool that has been implemented in the neonatal intensive care unit and studied in an extensive range of clinical applications in the past decade. This critical review aimed to evaluate a variety of clinical applications of aEEG monitoring in diagnosis, clinical management, and prognosis assessment in critically ill neonates. The databases of Pubmed, SciELO, Lilacs, and Cochrane, books, and other online resources were consulted, as well as sources of professional experiences. The clinical use of aEEG to access real-time brain function, background activity, and utility in seizures detection has been described. A critical review was realized considering the authors’ professional experience. Newborns with hypoxic-ischemic encephalopathy and seizures screening represent the most common studied population. However, several studies have shown interesting applications on preterm infants, newborns with congenital heart disease, and other clinical situations of high risk of injury to the developing brain. The aEEG has shown to be a useful non-invasive bedside monitor that aids in evaluating brain function, background activity, and cyclicity. aEEG findings have also demonstrated good prognostic value in a group of critically ill neonates. The aEEG seizure diagnosis capability has limitations, which have been already well established. The use of neonatal brain monitoring such as aEEG was shown to give valuable information in several high-risk clinical situations.