Delayed Onset of Sleep-Wake Cycling with Favorable Outcome in Hypothermic-Treated Neonates with Encephalopathy
Delayed Onset of Sleep-Wake Cycling with Favorable Outcome in Hypothermic-Treated Neonates with Encephalopathy
复制标题
DOI：
10.1016/j.jpeds.2011.01.006
复制
发表时间：
2011-08-01
影响因子：
5.1
通讯作者：
Perlman, Jeffrey M.
中科院分区：
文献类型：
--
作者：
Takenouchi, Toshiki;Rubens, Elayna O.;Perlman, Jeffrey M.
目的探讨低温是否能调节中重度缺氧缺血性脑病（hypoxic-ischemic encephalopathy，HIE）足月新生儿睡眠-觉醒周期的获得及其与预后的关系。研究设计：对29例中重度HIE足月新生儿进行选择性头部降温治疗。所有患者均在低温治疗期间进行振幅整合脑电图监测，并在低温治疗>= 72小时后立即进行视频脑电图监测。分析背景和睡眠-觉醒循环的脑电图数据。异常的结果包括死亡或严重的全球神经发育障碍>= 18 month.Results收购的睡眠-觉醒周期注意到在9个婴儿的72小时，13个96小时，19个120小时，22个144小时。睡眠-觉醒循环的存在与正常结果相关，即22例中有14例（64%），而与异常结果相关，即7例无睡眠-觉醒循环（P = 0.006）。在120小时内出现睡眠-觉醒循环的阳性预测值为68%，阴性预测值为90%。磁共振成像异常与睡眠-觉醒cycle.Conclusions虽然发病的睡眠-觉醒cycle. Conclusions在足月新生儿中重度缺氧缺血性脑病与低温治疗显着延迟，约65%的收购循环有一个正常的结果。睡眠-觉醒循环是评估中重度HIE足月儿低温治疗后恢复情况的重要辅助工具。（J Pediatr 2011; 159：232-7）。
Objective To determine whether hypothermia modulates acquisition of sleep-wake cycling in term neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE) and the relationship to outcome.Study design Twenty-nine term infants with moderate to severe HIE treated with selective head cooling were evaluated. All were monitored with amplitude-integrated electroencephalography during and video electroencephalography immediately after hypothermia for >= 72 hours. Electroencephalograpic data were analyzed for background and sleep-wake cycling. Abnormal outcome included death or severe global neurodevelopmental disability >= 18 months.Results Acquisition of sleep-wake cycling was noted in nine infants by 72 hours, in 13 by 96 hours, 19 by 120 hours, and 22 by 144 hours. Presence of sleep-wake cycling was associated with normal outcome, that is, 14 of 22 (64%), versus abnormal outcome, that is, none of seven without sleep-wake cycling (P = .006). The presence of sleep-wake cycling by 120 hours had a positive predictive value of 68% and negative predictive value of 90%. Magnetic resonance imaging abnormalities were related to onset of sleep-wake cycling.Conclusions Although onset of sleep-wake cycling is markedly delayed in term neonates with moderate to severe HIE treated with hypothermia, approximately 65% with acquisition of cycling have a normal outcome. Sleep-wake cycling is an important additional tool for assessing recovery in term infants with moderate to severe HIE treated with hypothermia. (J Pediatr 2011; 159: 232-7).