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Impact of Amplitude-Integrated Electroencephalograms on Clinical Care for …

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Shellhaas RA, Barks AK. Impact of amplitude-integrated electroencephalograms on clinical care for neonates with seizures. Pediatr Neurol. 2012 Jan;46(1):32-5. doi: 10.1016/j.pediatrneurol.2011.11.004. PubMed PMID: 22196488; PubMed Central PMCID: PMC3246404.

Amplitude-integrated EEG (aEEG) was introduced relatively recently into neonatal intensive care in the U.S.A. We aimed to evaluate whether aEEG has changed clinical care for neonates with seizures. All 202 neonates treated for seizures at our hospital from 2002 to 2007 were included in this study. Neonates monitored with aEEG (n=67) were compared to a contemporary control group of neonates who were not monitored, despite aEEG availability (n=57), and a historical control group of neonates treated for seizures before aEEG was introduced in our NICU (n=78). 82% of those treated with phenobarbital (137/167) continued treatment after discharge, with no difference among the groups. Adjusted for gestational age and length of stay, there was also no difference among groups in the number of neuroimaging studies or number of anticonvulsants per patient. Fewer patients in the aEEG group, compared to contemporary controls (n=16/67 vs. 29/57, p=0.001) or historical controls (n=38/78, p=0.002), were diagnosed clinically with seizures without electrographic confirmation. We conclude that introducing aEEG did not increase neuroimaging tests, nor did it alter anticonvulsant use. However, diagnostic precision for neonatal seizures improved after aEEG introduction, as fewer neonates were treated for seizures based solely on clinical findings, without electrographic confirmation.

Disponível Em: <https://www.ncbi.nlm.nih.gov/>