Expert consensus on grading management of electroencephalogram monitoring in neonates

Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association; Chinese Journal of Contemporary Pediatrics; National Health Commission Key Laboratory of Neonatal Diseases

Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (2) : 115-123.

PDF(648 KB)
PDF(648 KB)
Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (2) : 115-123. DOI: 10.7499/j.issn.1008-8830.2112129
STANDARD·PROTOCOL·GUIDELINE

Expert consensus on grading management of electroencephalogram monitoring in neonates

  • Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association; Chinese Journal of Contemporary Pediatrics; National Health Commission Key Laboratory of Neonatal Diseases
Author information +
History +

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

Cite this article

Download Citations
Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association; Chinese Journal of Contemporary Pediatrics; National Health Commission Key Laboratory of Neonatal Diseases. Expert consensus on grading management of electroencephalogram monitoring in neonates[J]. Chinese Journal of Contemporary Pediatrics. 2022, 24(2): 115-123 https://doi.org/10.7499/j.issn.1008-8830.2112129

References

1 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.
3 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.
5 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.
8 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.
9 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.
11 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.
12 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.
13 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.
14 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.
15 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.
16 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.
20 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.
23 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.
24 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.
25 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.
26 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.
27 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.
28 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.
30 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.
31 Trollmann R. Neuromonitoring in neonatal-onset epileptic encephalopathies[J]. Front Neurol, 2021, 12: 623625. PMID: 33603712. PMCID: PMC7884638. DOI: 10.3389/fneur.2021.623625.
32 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.
33 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.
34 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.
36 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.
37 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.
38 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.
39 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.
40 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.
41 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.
42 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.
43 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.
44 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.
45 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.
46 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.
48 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.
49 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.
50 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.
51 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.
52 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.
53 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.
54 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.
55 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.
56 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.
57 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.
PDF(648 KB)

Accesses

Citation

Detail

Sections
Recommended

/