Article Text

EFFECTS OF THE GAS USED IN NEONATAL RESUSCITATION ON THE CEREBRAL FUNCTIONS ANALYSED BY AMPLITUDE INTEGRATED EEG
  1. A I Toma1,
  2. D F Albu2,
  3. E Matu1,
  4. R Mitu1,
  5. I Rosca1,
  6. M Nanea1
  1. 1Neonatology Department, Panait Sarbu Hospital, Bucharest, Romania
  2. 2Fetal Medicine Department, Panait Sarbu Hospital, Bucharest, Romania

Abstract

Objective To compare the amplitude integrated EEG (aEEG) tracings in patients resuscitated at delivery with 21% or 100% oxygen.

Methods The aEEG tracings of neonates resuscitated at delivery that were randomly assigned to resuscitation with 21% oxygen (30 cases) or 100% oxygen (30 cases) were compared. There were noted: the type of encephalopathy (Sarnat classification), the background patterns at 2 h, 24 h, 72 h, the time of appearance of sleep–wake cycles (SWC), the seizure type and the time of cessation of seizures.

Results Normal SWC appeared earlier in the 21% oxygen group: 14.8 h (+6.36 h) than in the 100% oxygen group 22.7 h (+12.2 h) (p<0.03) when the entire sample was compared, and also in the case of Sarnat 1 patients: 5.63 h (+1.39 h) versus 7.95 h (+1.56 h) (p<0.027), Sarnat 2 patients: 29.6 h (+4.08 h) versus 52.7 h (+16.35 h) (p<0.001) but not in the case of Sarnat 3 patients. The background patterns did not differ significantly between the two groups in Sarnat 1 cases; there was a statistically significant difference in the subgroup of Sarnat 2 cases at 2 h (more cases with burst suppression and flat tracings in the 100% oxygen group (p<0.02). The seizures occurred later in the 21% oxygen group compared with the 100% oxygen group: 19.33 h (+4.5 h) versus 14.28 h (+2.43 h) (p<0.26), there was no difference in the time of cessation of seizures between the groups (p<0.201).

Conclusions The patients resuscitated at delivery with 21% oxygen have an earlier appearance of the SWC, a less severe background pattern and a later moment of occurrence of seizures than the patients resuscitated with 100% oxygen. This could be related to a better neurological prognosis in the cases of birth asphyxia resuscitated with 21% oxygen.

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