The Effect of Blood Base Deficit on Neonatal Convulsions and Amplitude Electroencephalography Measurements in Perinatal Asphyxia

Yıl 2024, , 207 - 214, 14.06.2024

Hüseyin Gümüş , Mehmet Kılıç

https://doi.org/10.5798/dicletip.1501221

Öz

Objective: To determine the effect of blood pH levels and base deficit on neonatal convulsions and amplitude electroencephalography measurements in patients with perinatal asphyxia.
Methods: This study included 102 patients monitored in the neonatal intensive care unit for perinatal asphyxia. Amplitude electroencephalography measurements and convulsions were recorded from all patients for 80 hours. Blood samples were taken in the umbilical artery for the pH analysis and calculation of base deficit.
Results: The mean gestational age was 38.13±1.30 weeks with 66/36 (64.7% / 35.3%), male/female ratio. Fifty-seven (55.9%) babies were delivered by normal spontaneous vaginal delivery, while 45 patients (44.1%) had a history of cesarean delivery. There were significant differences between the mean base deficit and amplitude electroencephalography recordings at the first 24th, 48th, and 72nd hours (KW=32.819, p<0.001; KW=23.687, p<0.001, and KW=24.992, p<0.001, respectively). Sixty-five (63.7%) of the patients had neonatal convulsions. The mean base deficit was 20.64±4.70 mmol/L and 17.48±2.92 mmol/L in patients with and without seizures, respectively. The mean base deficit was significantly higher in patients with neonatal seizures (Z=3.912; p=0.001).
Conclusion: Our study showed patients with abnormal amplitude electroencephalography findings and epileptic electrical activity were found to have higher base deficits at the time of diagnosis. It suggests that high base deficit levels may have a negative effect on the neurodevelopmental process in the neonatal period.

Anahtar Kelimeler

Amplitude electroencephalography, base deficit, convulsion, perinatal asphyxia

Kaynakça

• 1.P Li, L Hao, YY Guo, et al. Chloroquine inhibitsautophagy and deteriorates the mitochondrialdysfunction and apoptosis in hypoxic rat neurons.Life sciences. 2018;202:70-7.
• 2.Smith H. E. Noteworthy Professional News.Advances in Neonatal Care. 2019; 19.1: 3-4.
• 3.Bersani I, Ferrari F, Lugli L, et al. Monitoring theeffectiveness of hypothermia in perinatal asphyxiainfants by urinary S100B levels. Clinical Chemistryand Laboratory Medicine (CCLM). 2019; 57(7):1017-25.
• 4.SE Doman, A Girish, CL Nemeth, et al. earlyDetection of hypothermic neuroprotection UsingT2-Weighted Magnetic resonance imaging in aMouse Model of hypoxic ischemic encephalopathy.Frontiers in neurology. 2018; 9: 304.
• 5.Papile LA, Baley JE, Benitz W, et al. Hypothermiaand neonatal encephalopathy. Pediatrics.2014;133(6):1146–50.
• 6.Awal MA, Lai MM, Azemi G, et al. EEG backgroundfeatures that predict outcome in term neonates withhypoxic ischaemic encephalopathy: A structuredreview. Clinical Neurophysiology. 2016; 127(1):285-96.
• 7.Miller SP, Ramaswamy V, Michelson D, et al.Patterns of brain injury in term neonatalencephalopathy. J Pediatr. 2005;146(4):453–60.
• 8.Chandrasekaran M, Chaban B, Montaldo P, et al.Predictive value of amplitude-integrated EEG(aEEG) after rescue hypothermic neuroprotectionfor hypoxic ischemic encephalopathy: a meta-analysis. J Perinatol. 2017;37(6):684.
• 9.Dilena R, Raviglione F, Cantalupo G, et al.Consensus protocol for EEG and amplitude-integrated EEG assessment and monitoring inneonates. Clin Neurophysiol. 2021;132(4):886-903.Ziobro J, Shellhaas RA. Neonatal Seizures: Diagnosis, Etiologies, and Management. Semin Neurol. 2020;40(2):246-56.
• 10.Perlman JM, Wyllie J, Kattwinkel J, et al. NeonatalResuscitation Chapter Collaborators. Part 11:Neonatal resuscitation: 2010 InternationalConsensus on Cardiopulmonary Resuscitation andEmergency Cardiovascular Care Science WithTreatment Recommendations. Circulation.2010;122(16 Suppl 2):516-38.
• 11.Procianoy RS. Hipotermia terapêutica. SBP.Departamento de Neonatologia. Documentocientífico [cited 2015 Jul 25].
• 12.Skranes JH, Løhaugen G, Schumacher EM, et al.Amplitude-integrated electroencephalographyimproves the identification of infants withencephalopathy for therapeutic hypothermia andpredicts neurodevelopmental outcomes at 2 years of age. The Journal of pediatrics. 2017; 187: 34-42.
• 13.Hellström-Westas L, Rosén I, De Vries LS, et al.Amplitude-integrated EEG classification andinterpretation in preterm and term infants.Neoreviews. 2006;7(2):76–87.
• 14.Yuan X, Song J, Gao L, et al. Early amplitude-integrated electroencephalogram predicts long-term outcomes in term and near-term newbornswith severe hyperbilirubinemia. Pediatr Neurol2019.
• 15.Shany E, Khvatskin S, Golan A, et al. Amplitude-integrated electroencephalography: a tool formonitoring silent seizures in neonates. PediatrNeurol. 2006;34(3):194–9.
• 16.R Del Río, C Ochoa, A Alarcon, et al. Amplitudeintegrated electroencephalogram as a prognostictool in neonates with hypoxic‐ischemicencephalopathy: a systematic review PLoS One.2016;11(11):0165744.
• 17.Gucuyener K. Use of Amplitude-integratedelectroencephalography in neonates with specialemphasis on Hypoxic-ischemic encephalopathy andtherapeutic hypothermia. J Clin Neonatol 2016;5:18-30.
• 18.Obeid R., Tsuchida TN. Treatment effects onneonatal EEG. Journal of Clinical Neurophysiology,2016; 33(5): 376-81.
• 19.Hallberg B, Grossmann K, Bartocci M, et al. Theprognostic value of early aEEG in asphyxiatedinfants undergoing systemic hypothermiatreatment. Acta Paediatr. 2010;99(4):531–6.
• 20. Aluvaala J, Collins GS, Maina M, et al. A systematic review of neonatal treatment intensity scores andtheir potential application in low-resource settinghospitals for predicting mortality, morbidity andestimating resource use. Systematic reviews. 2017;6(1): 248.
• 21.Hellström-Westas L, Rosén I, De Vries LS, et al.Amplitude-integrated EEG classification andinterpretation in preterm and term infants.NeoReviews. 2006; 7(2): 76-87.
• 22.Qian J, Zhou D, Wang YW. Umbilical artery bloodS100β protein: a tool for the early identification ofneonatal hypoxic-ischemic encephalopathy.European journal of pediatrics. 2009; 168(1): 71-7.
• 23.Shellhaas RA, Gallagher PR, Clancy RR.Assessment of neonatal electroencephalography(EEG) background by conventional and twoamplitude-integrated EEG classification systems. JPediatr. 2008;153(3):369–74.
• 24. Akçay A, Yılmaz S, Tanrıverdi S, et al. ComparisonBetween Simultaneously Recorded AmplitudeIntegrated Electroencephalography and StandardElectroencephalography in Neonates with AcuteBrain Injury. J Pediatr Res. 2015;2(4):187–92.
• 25.Luo F, Chen Z, Lin H, et al.. Evaluation of cerebralfunction in high risk term infants by using a scoringsystem based on aEEG. Transl Pediatr.2014;3(4):278.
• 26.Thorp JA, Rushing RS. Umbilical cord bloodanalysis.Clin Obstet Gynecol 1999; 26(4): 695-709.