Med Bull Sisli Etfal Hosp. Accepted Articles: SETB-28913 | DOI: 10.14744/SEMB.2025.28913

aEEG Assessment for Short-Term Outcome Prognosis Prediction in Hypoxic Ischemic Encephalopathy: An 11-Year Experience

Muhittin Celik¹, Ali Bulbul², Osman Akdeniz^3
1Department of Pediatrics/Neonatology, Diyarbakir Children's Diseases Hospital, Diyarbakir, Türkiye; Department of Pediatrics/Neonatology, Private Medical Point Hospital, Gaziantep, Türkiye
²Department of Neonatology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
³Department of Pediatrics/Cardiology, Diyarbakir Children's Diseases Hospital, Diyarbakir, Türkiye

Objective: Hypoxic-ischemic encephalopathy (HIE) continues to be a predominant cause of morbidity and mortality in neonates. Therapeutic hypothermia (TH) is the only method with proven neuroprotective effects, and the aim of this study was to evaluate the short-term results of patients treated with TH.
Methods: Demographic, clinical characteristics, laboratory and aEEG results of patients who received TH treatment with a diagnosis of Stage II or Stage III HIE according to modified Sarnat staging in the Neonatal Intensive Care Unit were analyzed retrospectively.
Results: A total of 101 patients were included in the study. The mean gestational age of the patients was 38.8±1.5 weeks, the mean birth weight was 3215±499.5 g, and 40.6% were female. According to the modified Sarnat staging, 50.5% of the patients were evaluated as Stage II, and the others as Stage III HIE. The most common peripartum risk factors were meconium delivery (25.7%) and prolonged or difficult labor (20.7%). Mortality rates in patients with Stage II and Stage III HIE were 5.9% and 26%, respectively. One of the patients who died, the 6th hour aEEG background activity was moderately abnormal, and in 15 patients there was a severely abnormal voltage pattern. Acute kidney injury was found to be the most effective factor in mortality.
Conclusions: In our study, it was concluded that the mortality rate of newborns diagnosed with Stage III HIE was higher, the most impact factor on mortality was acute kidney injury, and 6th hour voltage activity in aEEG monitoring was useful in predicting prognosis.

Keywords: Electroencephalography, hypoxic ischemic encephalopathy, neonate, therapeutic hypothermia

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Hipoksik Ýskemik Ensefalopatide Kýsa Dönem Prognoz Tahmini için aEEG Deðerlendirmesi: 11-Yýllýk Deneyim

Muhittin Celik¹, Ali Bulbul², Osman Akdeniz^3
1Diyarbakýr Çocuk Hastalýklarý Hastanesi, Pediatri/Neonatoloji Kliniði, Diyarbakýr; Özel Medical Point Hastanesi, Pediatri/Neonatoloji Kliniði, Gaziantep
²Türkiye Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Neonatoloji Kliniði, Ýstanbul
³Diyarbakýr Çocuk Hastalýklarý Hastanesi, Pediatri/Kardiyoloji Kliniði, Diyarbakýr

Amaç: Hipoksik iskemik ensefalopati (HÝE), yenidoðan morbidite ve mortalitesinin önde gelen nedeni olmaya devam etmektedir. Terapötik hipotermi (TH) nöroprotektif etkisi kanýtlanmýþ tek yöntem olup, bu çalýþmanýn amacý, TH uygulanan hastalarýn kýsa dönem sonuçlarýný deðerlendirmektir.
Yöntemler: Yenidoðan Yoðun Bakým Ünitesi’nde modifiye Sarnat evrelemesine göre Evre II veya Evre III HÝE tanýsý ile TH tedavisi alan hastalarýn demografik, klinik özellikleri, laboratuvar ve aEEG sonuçlarý retrospektif olarak analiz edildi.
Bulgular: Çalýþmaya toplam 101 hasta dahil edildi. Hastalarýn gebelik yaþ ortalamasý 38,8±1,5 hafta, doðum aðýrlýðý ortalamasý 3215±499,5 g ve %40,6’sý kýzdý. Modifiye Sarnat evrelemesine göre hastalarýn %50,5’i Evre II, diðerleri Evre III HÝE olarak deðerlendirildi. En sýk peripartum risk faktörleri mekonyumlu doðum (%25,7) ve uzamýþ veya zor travaydý (%20,7). Evre II ve Evre III HÝE olan hastalarda mortalite oranlarý sýrasýyla %5,9 ve %26 idi. Exitus olan hastalarýn 6. saat aEEG arka plan aktivitesi, bir hastada orta derecede anormal, 15 hastada ise aðýr derecede anormal voltaj olduðu saptandý. Mortaliteye en etkili faktör ise akut böbrek hasarý idi.
Sonuç: Çalýþmamýzda, Evre III HÝE tanýlý yenidoðanlarýn ölüm oranlarý daha fazla olduðu, mortaliteye en etkilifaktörün akut böbrek hasarý olduðu, aEEG izleminde 6. saat voltaj aktivitesinin prognozu öngörmede yararlý olduðu sonucuna ulaþýlmýþtýr. (SETB-2025-01-08)

Anahtar Kelimeler: Elektroensefalografi, hipoksik iskemik ensefalopati, yenidoðan, terapötik hipotermi

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