Background and aims Asphyxiated neonates are at risk for developing hypoxic ischaemic encephalopathy and seizures. Although conventional electroencephalography (cEEG) is the standard method to detect subclinical seizures and encephalopathy, aEEG is a validated bedside screening tool used in routine clinical practice in many NICUs.

Our Hospital is a non-referral hospital without NICU facilities. Neonates meeting the criteria for therapeutic hypothermia need to be transported to a NICU. The diagnostic value of aEEG monitoring in a non-NICU setting is unknown. We hypothesised aEEG monitoring in a non-NICU setting adds value to diagnostic and therapeutic decision making in asphyxiated neonates.

Methods A retrospective analysis was performed on all asphyxiated neonates born from January 2011 untill July 2013 in our hospital. Asphyxia was defined as Apgar score ≤5 after 5 min or rescusitation or ventilation from birth for 10 min or pH <7.0 and base deficit >16 mmol/L or lactic acid >10.0 mmol/L.

Results We evaluated 57 asphyxiated neonates of which 12 neonates were directly intubated and transported to NICU. In 7 out of 45(15,5%) asphyxiated neonates the performed aEEG had diagnostic consequences. Finally, 4 out of 7 neonates (9%) were treated for subclinical seizures (n = 3) or therapeutic hypothermia (n = 1).

Conclusions aEEG monitoring in a non-NICU setting adds diagnostic and therapeutic value in asphyxiated neonates, especially in the recognition of subclinical seizures.