Evaluation of amplitude-integrated EEG use in the neonatal intensive care unit

Aim: Amplitude-integrated electroencephalogram (aEEG) is widely used in neonatal intensive care units (NICU), as it is easier to interpret than conventional EEG and does not prevent invasive procedures in infants. Although it is frequently used in the diagnosis and follow-up of Hypoxic Ischemic Encephalopathy (HIE) and neonatal convulsions developing after perinatal asphyxia, the relationship between neurological examination, aEEG and conventional EEG (cEEG) is still not fully understood. Material and Methods: This study was carried out by retrospective evaluation of the patient's files and aEEG records of 59 infants who were followed up with aEEG in the Neonatal Intensive Care Unit of Karabuk University Training and Research Hospital between January 1, 2020 and January 31, 2022. One infant who was beyond the neonatal period was not included in the analysis. The data of 38 infants with perinatal asphyxia and 20 infants who were prediagnosed with convulsions were evaluated. Results: aEEG results of the infants diagnosed with perinatal asphyxia were found to be highly consistent with neurological examination in the early and late periods (84.2%). However, convulsion was detected in aEEG only in 20% of 20 infants with abnormal movements clinically suggestive of convulsions. Discussion: Our study revealed that the use of aEEG is beneficial in infants who develop HIE after perinatal asphyxia but its benefit in the diagnosis and follow-up of neonatal seizures is not clear. We believe that the use of multi-channel aEEG and/or the use of aEEG together with conventional EEG in neonatal convulsion follow-up will provide more useful information.