Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

July 16, 2013; 81 (3) Article

Limited short-term prognostic utility of cerebral NIRS during neonatal therapeutic hypothermia

Renée A. Shellhaas, Brian J. Thelen, Jayapalli R. Bapuraj, Joseph W. Burns, Aaron W. Swenson, Mary K. Christensen, Stephanie A. Wiggins, John D.E. Barks
First published June 14, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31829bfe41
Renée A. Shellhaas
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brian J. Thelen
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jayapalli R. Bapuraj
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joseph W. Burns
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Aaron W. Swenson
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mary K. Christensen
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stephanie A. Wiggins
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John D.E. Barks
From the Departments of Pediatrics and Communicable Diseases (R.A.S., M.K.C., S.A.W., J.D.E.B.) and Radiology (J.R.B.), University of Michigan, Ann Arbor; Michigan Tech Research Institute (B.J.T., J.W.B.), Ann Arbor and Children's Hospital and Clinics of Minnesota-Minneapolis (A.W.S.), Minnesota Neonatal Physicians, Minneapolis.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Limited short-term prognostic utility of cerebral NIRS during neonatal therapeutic hypothermia
Renée A. Shellhaas, Brian J. Thelen, Jayapalli R. Bapuraj, Joseph W. Burns, Aaron W. Swenson, Mary K. Christensen, Stephanie A. Wiggins, John D.E. Barks
Neurology Jul 2013, 81 (3) 249-255; DOI: 10.1212/WNL.0b013e31829bfe41

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
606

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective: We evaluated the utility of amplitude-integrated EEG (aEEG) and regional oxygen saturation (rSO2) measured using near-infrared spectroscopy (NIRS) for short-term outcome prediction in neonates with hypoxic ischemic encephalopathy (HIE) treated with therapeutic hypothermia.

Methods: Neonates with HIE were monitored with dual-channel aEEG, bilateral cerebral NIRS, and systemic NIRS throughout cooling and rewarming. The short-term outcome measure was a composite of neurologic examination and brain MRI scores at 7 to 10 days. Multiple regression models were developed to assess NIRS and aEEG recorded during the 6 hours before rewarming and the 6-hour rewarming period as predictors of short-term outcome.

Results: Twenty-one infants, mean gestational age 38.8 ± 1.6 weeks, median 10-minute Apgar score 4 (range 0–8), and mean initial pH 6.92 ± 0.19, were enrolled. Before rewarming, the most parsimonious model included 4 parameters (adjusted R2 = 0.59; p = 0.006): lower values of systemic rSO2 variability (p = 0.004), aEEG bandwidth variability (p = 0.019), and mean aEEG upper margin (p = 0.006), combined with higher mean aEEG bandwidth (worse discontinuity; p = 0.013), predicted worse short-term outcome. During rewarming, lower systemic rSO2 variability (p = 0.007) and depressed aEEG lower margin (p = 0.034) were associated with worse outcome (model-adjusted R2 = 0.49; p = 0.005). Cerebral NIRS data did not contribute to either model.

Conclusions: During day 3 of cooling and during rewarming, loss of physiologic variability (by systemic NIRS) and invariant, discontinuous aEEG patterns predict poor short-term outcome in neonates with HIE. These parameters, but not cerebral NIRS, may be useful to identify infants suitable for studies of adjuvant neuroprotective therapies or modification of the duration of cooling and/or rewarming.

GLOSSARY

aEEG=
amplitude-integrated EEG;
HIE=
hypoxic ischemic encephalopathy;
NICU=
neonatal intensive care unit;
NIRS=
near-infrared spectroscopy;
rSO2=
regional oxygen saturation;
TOI=
tissue oxygenation index

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received December 7, 2012.
  • Accepted in final form March 29, 2013.
  • © 2013 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

  • In reply: Prognostic value of cerebral NIRS after perinatal asphyxia
    • Renee A Shellhaas, pediatric neurologist, University of Michigan, Ann Arbor, MIshellhaa@med.umich.edu
    • John Barks, Ann Arbor, MI
    Submitted February 12, 2014
  • Prognostic value of cerebral NIRS after perinatal asphyxia
    • Petra M Lemmers, pediatrician neonatologist, Wilhelmina Children's Hospital/UMCU Utrecht Netherlandsplemmers@umcutrecht.nl
    • Laura ML Dix, Utrecht, NL; Mona C Toet, Utrecht, NL; Frank van Bel, Utrecht, NL.
    Submitted October 16, 2013
Comment

NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • ACKNOWLEDGMENT
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Topics Discussed

  • Neonatal

Alert Me

  • Alert me when eletters are published
Neurology: 96 (15)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2021 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise