新生儿脑电生理监测分级管理专家共识

doi:10.7499/j.issn.1008-8830.2112129

摘要
图/表
参考文献(57)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (648 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要美国临床神经生理学协会已经发表了新生儿脑电图监测指南，中国也发表了新生儿振幅整合脑电图（amplitude-integrated electroencephalogram，aEEG）专家共识。由于缺乏脑电监测设备和专业解读人员，不同级别的新生儿病房很难严格按照指南或共识进行脑电监测。中华医学会儿科学分会新生儿学组成立了由新生儿、儿童神经和神经电生理专业人员组成的专家组对已经发表的指南和专家共识及相关领域的文献进行审查，建立了适用于不同级别新生儿病房脑电监测的分层管理建议。基于视频脑电图和aEEG特点，根据当地医疗资源和患儿疾病特征，专家组认为视频脑电图和aEEG可以互相补充应用，适用于不同级别的新生儿病房。该共识对促进新生儿、儿童神经和神经电生理专业人员之间的合作和远程脑电监测实施提出了建议。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：脑电图, 振幅整合脑电图, 癫痫发作, 脑病, 专家共识, 高危儿, 新生儿

Abstract：Neonatal electroencephalogram (EEG) monitoring guidelines have been published by American Clinical Neurophysiology Society, and the expert consensus on neonatal amplitude-integrated EEG (aEEG) has also been published in China. It is difficult to strictly follow the guidelines or consensus for EEG monitoring in different levels of neonatal units due to a lack of EEG monitoring equipment and professional interpreters. The Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association, established an expert group composed of professionals in neonatology, pediatric neurology, and brain electrophysiology to review published guidelines and consensuses and the articles in related fields and propose grading management recommendations for EEG monitoring in different levels of neonatal units. Based on the characteristics of video EEG and aEEG, local medical resources, and disease features, the expert group recommends that video EEG and aEEG can complement each other and can be used in different levels of neonatal units. The consensus also gives recommendations for promoting collaboration between professionals in neonatology, pediatric neurology, and brain electrophysiology and implementing remote EEG monitoring.

Key words： Electroencephalogram Amplitude-integrated electroencephalogram Seizure Encephalopathy Expert consensus High-risk infant Neonate

收稿日期: 2021-12-28

通讯作者: 周文浩，男，主任医师，复旦大学附属儿科医院新生儿科/国家卫生健康委员会新生儿疾病重点实验室，Email：zhouwenhao@fudan.edu.cn E-mail: zhouwenhao@fudan.edu.cn

引用本文:

. 新生儿脑电生理监测分级管理专家共识[J]. 中国当代儿科杂志, 2022, 24(2): 115-123.

. Expert consensus on grading management of electroencephalogram monitoring in neonates[J]. CJCP, 2022, 24(2): 115-123.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2112129 或 http://www.zgddek.com/CN/Y2022/V24/I2/115

	Novak CM, Ozen M, Burd I. Perinatal brain injury: mechanisms, prevention, and outcomes[J]. Clin Perinatol, 2018, 45(2): 357-375. PMID: 29747893. DOI: 10.1016/j.clp.2018.01.015.
	2 王来栓, 程国强, 周文浩. 新生儿缺氧缺血性脑病后亚低温时代管理新思考[J]. 中华围产医学杂志, 2020, 23(3): 172-176. DOI: 10.3760/cma.j.cn113903-20190805-00480.
	Pressler RM, Cilio MR, Mizrahi EM, et al. The ILAE classification of seizures and the epilepsies: modification for seizures in the neonate. Position paper by the ILAE Task Force on Neonatal Seizures[J]. Epilepsia, 2021, 62(3): 615-628. PMID: 33522601. DOI: 10.1111/epi.16815.
	4 张鹏, 许艳, 程国强, 等. 国际抗癫痫联盟新生儿癫痫发作分类特别工作组专家建议解读(2021年)[J]. 中华实用儿科临床杂志, 2021, 36(20): 1534-1537. DOI: 10.3760/cma.j.cn101070-20210811-00957.
	Shellhaas RA, Chang T, Tsuchida T, et al. The American Clinical Neurophysiology Society's guideline on continuous electroencephalography monitoring in neonates[J]. J Clin Neurophysiol, 2011, 28(6): 611-617. PMID: 22146359. DOI: 10.1097/WNP.0b013e31823e96d7.
	6 俞秀雅, 程国强, 周文浩. 新生儿神经重症监护单元如何应用振幅整合脑电图[J]. 中国循证儿科杂志, 2015, 10(2): 119-125. DOI: 10.3969/j.issn.1673-5501.2015.02.008.
	7 中华医学会儿科学分会围产专业委员会. 新生儿振幅整合脑电图临床应用专家共识[J]. 中华新生儿科杂志(中英文), 2019, 34(1): 3-7. DOI: 10.3760/cma.j.issn.2096-2932.2019.01.002.
	Tsuchida TN, Wusthoff CJ, Shellhaas RA, et al. American Clinical Neurophysiology Society standardized EEG terminology and categorization for the description of continuous EEG monitoring in neonates: report of the American Clinical Neurophysiology Society critical care monitoring committee[J]. J Clin Neurophysiol, 2013, 30(2): 161-173. PMID: 23545767. DOI: 10.1097/WNP.0b013e3182872b24.
	Malfilatre G, Mony L, Hasaerts D, et al. Technical recommendations and interpretation guidelines for electroencephalography for premature and full-term newborns[J]. Neurophysiol Clin, 2021, 51(1): 35-60. PMID: 33168466. DOI: 10.1016/j.neucli.2020.10.005.
	10 上海市医学会脑电图与临床神经生理专科分会. 临床脑电图操作规范的上海专家共识[J]. 上海医学, 2021, 44(3): 141-147. DOI: 10.19842/j.cnki.issn.0253-9934.2021.03.001.
	Dilena R, Raviglione F, Cantalupo G, et al. Consensus protocol for EEG and amplitude-integrated EEG assessment and monitoring in neonates[J]. Clin Neurophysiol, 2021, 132(4): 886-903. PMID: 33684728. DOI: 10.1016/j.clinph.2021.01.012.
	André-Obadia N, Lamblin MD, Sauleau P. French recommendations on electroencephalography[J]. Neurophysiol Clin, 2015, 45(1): 1-17. PMID: 25637362. DOI: 10.1016/j.neucli.2014.11.002.
	Backman S, Rosén I, Blennow M, et al. Swedish consensus reached on recording, interpretation and reporting of neonatal continuous simplified electroencephalography that is supported by amplitude-integrated trend analysis[J]. Acta Paediatr, 2018, 107(10): 1702-1709. PMID: 29897141. DOI: 10.1111/apa.14460.
	Boylan G, Burgoyne L, Moore C, et al. An international survey of EEG use in the neonatal intensive care unit[J]. Acta Paediatr, 2010, 99(8): 1150-1155. PMID: 20353503. DOI: 10.1111/j.1651-2227.2010.01809.x.
	Buttle SG, Sell E, Webster R, et al. Continuous electroencephalography monitoring for critically ill neonates: a Canadian perspective[J]. Can J Neurol Sci, 2019, 46(4): 394-402. PMID: 31030685. DOI: 10.1017/cjn.2019.36.
	Wang Z, Zhang P, Zhou WH, et al. Electroencephalography monitoring in the neonatal intensive care unit: a Chinese perspective[J]. Transl Pediatr, 2021, 10(3): 552-559. PMID: 33850813. PMCID: PMC8039787. DOI: 10.21037/tp-20-340.
	17 中华医学会儿科学分会新生儿学组, 中国当代儿科杂志编辑委员会, 国家卫生健康委员会新生儿疾病重点实验室. 新生儿脑电图操作和报告书写最低技术标准专家共识[J]. 中国当代儿科杂志, 2021, 24(2): 124-131. DOI: 10.7499/j.issn.1008-8830.2112130.
	18 黄秀清, 程国强. 新生儿脑病: 多病因识别[J]. 中国小儿急救医学, 2021, 28(8): 649-653. DOI: 10.3760/cma.j.issn.1673-4912.2021.08.002.
	19 新生儿神经重症监护单元建设专家共识工作组, 中华医学会儿科学分会新生儿学组. 新生儿神经重症监护单元建设专家共识[J]. 中国循证儿科杂志, 2018, 13(4): 241-247. DOI: 10.3969/j.issn.1673-5501.2018.04.001.
	Chalak L, Hellstrom-Westas L, Bonifacio S, et al. Bedside and laboratory neuromonitoring in neonatal encephalopathy[J]. Semin Fetal Neonatal Med, 2021, 26(5): 101273. PMID: 34393094. PMCID: PMC8627431. DOI: 10.1016/j.siny.2021.101273.
	21 徐素华, 许艳, 杨琳, 等. 新生儿遗传代谢病视频脑电图和头颅磁共振特点及其对预后的预测价值[J]. 中华新生儿科杂志, 2021, 36(5): 45-49. DOI: 10.3760/cma.j.issn.2096-2932.2021.05.010.
	22 王乐, 程国强. 新生儿体外膜肺氧合期间的神经监护和评估[J]. 中华实用儿科临床杂志, 2020, 35(14): 1113-1116. DOI: 10.3760/cma.j.cn101070-20190717-00654.
	Pisani F, Spagnoli C. Monitoring of newborns at high risk for brain injury[J]. Ital J Pediatr, 2016, 42(1): 48. PMID: 27180227. PMCID: PMC4867092. DOI: 10.1186/s13052-016-0261-8.
	Boylan GB, Kharoshankaya L, Mathieson SR. Diagnosis of seizures and encephalopathy using conventional EEG and amplitude integrated EEG[J]. Handb Clin Neurol, 2019, 162: 363-400. PMID: 31324321. DOI: 10.1016/B978-0-444-64029-1.00018-7.
	Bonifacio SL, Hutson S. The term newborn: evaluation for hypoxic-ischemic encephalopathy[J]. Clin Perinatol, 2021, 48(3): 681-695. PMID: 34353587. DOI: 10.1016/j.clp.2021.05.014.
	Awal MA, Lai MM, Azemi G, et al. EEG background features that predict outcome in term neonates with hypoxic ischaemic encephalopathy: a structured review[J]. Clin Neurophysiol, 2016, 127(1): 285-296. PMID: 26105684. DOI: 10.1016/j.clinph.2015.05.018.
	Lemyre B, Chau V. Hypothermia for newborns with hypoxic-ischemic encephalopathy[J]. Paediatr Child Health, 2018, 23(4): 285-291. PMID: 30657134. PMCID: PMC6007306. DOI: 10.1093/pch/pxy028.
	Wusthoff CJ, Clark CL, Glass HC, et al. Cooling in neonatal hypoxic-ischemic encephalopathy: practices and opinions on minimum standards in the state of California[J]. J Perinatol, 2018, 38(1): 54-58. PMID: 29048405. DOI: 10.1038/jp.2017.153.
	29 卫生部新生儿疾病重点实验室, 复旦大学附属儿科医院. 亚低温治疗新生儿缺氧缺血性脑病方案(2011)[J]. 中国循证儿科杂志, 2011, 6(5): 337-339. DOI: 10.3969/j.issn.1673-5501.2011.05.005.
	Jacobs SE, Berg M, Hunt R, et al. Cooling for newborns with hypoxic ischaemic encephalopathy[J]. Cochrane Database Syst Rev, 2013, 2013(1): CD003311. PMID: 23440789. PMCID: PMC7003568. DOI: 10.1002/14651858.CD003311.pub3.
	Trollmann R. Neuromonitoring in neonatal-onset epileptic encephalopathies[J]. Front Neurol, 2021, 12: 623625. PMID: 33603712. PMCID: PMC7884638. DOI: 10.3389/fneur.2021.623625.
	Malone A, Ryan CA, Fitzgerald A, et al. Interobserver agreement in neonatal seizure identification[J]. Epilepsia, 2009, 50(9): 2097-2101. PMID: 19490044. DOI: 10.1111/j.1528-1167.2009.02132.x.
	Massey SL, Jensen FE, Abend NS. Electroencephalographic monitoring for seizure identification and prognosis in term neonates[J]. Semin Fetal Neonatal Med, 2018, 23(3): 168-174. PMID: 29352657. DOI: 10.1016/j.siny.2018.01.001.
	Rennie JM, de Vries LS, Blennow M, et al. Characterisation of neonatal seizures and their treatment using continuous EEG monitoring: a multicentre experience[J]. Arch Dis Child Fetal Neonatal Ed, 2019, 104(5): F493-F501. PMID: 30472660. PMCID: PMC6788873. DOI: 10.1136/archdischild-2018-315624.
	35 朱小妹, 邱鹏玲, 程国强, 等. 同步视频脑电图监测下双导振幅整合脑电图诊断新生儿惊厥的价值[J]. 中华围产医学杂志, 2012, 15(12): 720-726. DOI: 10.3760/cma.j.issn.1007-9408.2012.12.004.
	Nunes ML, Yozawitz EG, Zuberi S, et al. Neonatal seizures: is there a relationship between ictal electroclinical features and etiology? A critical appraisal based on a systematic literature review[J]. Epilepsia Open, 2019, 4(1): 10-29. PMID: 30868112. PMCID: PMC6398099. DOI: 10.1002/epi4.12298.
	Pisani F, Facini C, Pavlidis E, et al. Epilepsy after neonatal seizures: literature review[J]. Eur J Paediatr Neurol, 2015, 19(1): 6-14. PMID: 25455712. DOI: 10.1016/j.ejpn.2014.10.001.
	Pisani F, Prezioso G, Spagnoli C. Neonatal seizures in preterm infants: a systematic review of mortality risk and neurological outcomes from studies in the 2000's[J]. Seizure, 2020, 75: 7-17. PMID: 31864147. DOI: 10.1016/j.seizure.2019.12.005.
	Ryu S, Back S, Lee S, et al. Pilot study of a single-channel EEG seizure detection algorithm using machine learning[J]. Childs Nerv Syst, 2021, 37(7): 2239-2244. PMID: 33939017. DOI: 10.1007/s00381-020-05011-9.
	Dong XR, Kong YT, Xu Y, et al. Development and validation of auto-neo-electroencephalography (EEG) to estimate brain age and predict report conclusion for electroencephalography monitoring data in neonatal intensive care units[J]. Ann Transl Med, 2021, 9(16): 1290. PMID: 34532427. PMCID: PMC8422089. DOI: 10.21037/atm-21-1564.
	Pavel AM, Rennie JM, de Vries LS, et al. A machine-learning algorithm for neonatal seizure recognition: a multicentre, randomised, controlled trial[J]. Lancet Child Adolesc Health, 2020, 4(10): 740-749. PMID: 32861271. PMCID: PMC7492960. DOI: 10.1016/S2352-4642(20)30239-X.
	Xu Y, Dou YL, Chen X, et al. Early initial video-electro-encephalography combined with variant location predict prognosis of KCNQ2-related disorder[J]. BMC Pediatr, 2021, 21(1): 477. PMID: 34711204. PMCID: PMC8555078. DOI: 10.1186/s12887-021-02946-z.
	Pavlidis E, Lloyd RO, Boylan GB. EEG—a valuable biomarker of brain injury in preterm infants[J]. Dev Neurosci, 2017, 39(1-4): 23-35. PMID: 28402972. DOI: 10.1159/000456659.
	Bourel-Ponchel E, Lamblin MD. EEG in premature newborns[J]. Neurophysiol Clin, 2021, 51(1): 1-3. PMID: 33121879. DOI: 10.1016/j.neucli.2020.10.007.
	Hellstr?m-Westas L. Amplitude-integrated electroencephalography for seizure detection in newborn infants[J]. Semin Fetal Neonatal Med, 2018, 23(3): 175-182. PMID: 29472139. DOI: 10.1016/j.siny.2018.02.003.
	Macdonald-Laurs E, Sharpe C, Nespeca M, et al. Does the first hour of continuous electroencephalography predict neonatal seizures?[J]. Arch Dis Child Fetal Neonatal Ed, 2021, 106(2): 162-167. PMID: 32928896. DOI: 10.1136/archdischild-2020-318985.
	47 施亿赟, 程国强, 邵肖梅, 等. 正常早产儿振幅整合脑电图特点的研究[J]. 中华儿科杂志, 2011, 49(9): 648-654. DOI: 10.3760/cma.j.issn.0578-1310.2011.09.003.
	André M, Lamblin MD, d'Allest AM, et al. Electroencephalography in premature and full-term infants. Developmental features and glossary[J]. Neurophysiol Clin, 2010, 40(2): 59-124. PMID: 20510792. DOI: 10.1016/j.neucli.2010.02.002.
	Lee ES, Kim EK, Shin SH, et al. Factors associated with neurodevelopment in preterm infants with systematic inflammation[J]. BMC Pediatr, 2021, 21(1): 114. PMID: 33685414. PMCID: PMC7938564. DOI: 10.1186/s12887-021-02583-6.
	张漪, 付佳敏, 夏世文. 支气管肺发育不良早产儿振幅整合脑电图的临床意义分析[J]. 中国当代儿科杂志, 2021, 23(2): 127-132. PMID: 33627205. PMCID: PMC7921530. DOI: 10.7499/j.issn.1008-8830.2009110.
	Tandircioglu UA, Guzoglu N, Gucuyener K, et al. Influence of intensive care unit enlightenment on premature infants on functional brain maturation assessed by amplitude-integrated electroencephalograph[J]. Am J Perinatol, 2021, 38(4): 357-362. PMID: 31683326. DOI: 10.1055/s-0039-1697681.
	Fitzgerald MP, Massey SL, Fung FW, et al. Expanding access to continuous EEG monitoring in neonatal intensive care units[J]. J Clin Neurophysiol, 2021, 38(6): 525-529. PMID: 32541608. DOI: 10.1097/WNP.0000000000000730.
	Sharpe C, Davis SL, Reiner GE, et al. Assessing the feasibility of providing a real-time response to seizures detected with continuous long-term neonatal electroencephalography monitoring[J]. J Clin Neurophysiol, 2019, 36(1): 9-13. PMID: 30289769. PMCID: PMC6320287. DOI: 10.1097/WNP.0000000000000525.
	Goswami I, Bello-Espinosa L, Buchhalter J, et al. Introduction of continuous video EEG monitoring into 2 different NICU models by training neonatal nurses[J]. Adv Neonatal Care, 2018, 18(4): 250-259. PMID: 29889725. DOI: 10.1097/ANC.0000000000000523.
	Bonifacio SL, Van Meurs K. Neonatal neurocritical care: providing brain-focused care for all at risk neonates[J]. Semin Pediatr Neurol, 2019, 32: 100774. PMID: 31813520. DOI: 10.1016/j.spen.2019.08.010.
	Falsaperla R, Mauceri L, Motta M, et al. From neonatal intensive care to neurocritical care: is it still a mirage? The Sicilian multicenter project[J]. Crit Care Res Pract, 2021, 2021: 1782406. PMID: 34426771. PMCID: PMC8380151. DOI: 10.1155/2021/1782406.
	Wilson D, Young J. Sharing knowledge to enhance neonatal neurocritical care[J]. Neonatal Netw, 2020, 39(3): 115. PMID: 32457185. DOI: 10.1891/0730-0832.39.3.115.