Bedside and laboratory neuromonitoring in neonatal encephalopathy

L Chalak; L Hellstrom-Westas; S Bonifacio; T Tsuchida; V Chock; M El-Dib; An N Massaro; A Garcia-Alix; Newborn Brain Society Guidelines and Publications

doi:10.1016/j.siny.2021.101273

Bedside and laboratory neuromonitoring in neonatal encephalopathy

Semin Fetal Neonatal Med. 2021 Oct;26(5):101273. doi: 10.1016/j.siny.2021.101273. Epub 2021 Jul 28.

Authors

L Chalak¹, L Hellstrom-Westas², S Bonifacio³, T Tsuchida⁴, V Chock⁵, M El-Dib⁶, An N Massaro⁷, A Garcia-Alix⁸; Newborn Brain Society Guidelines and Publications

Affiliations

¹ University of Texas Southwestern Medical Center, Dallas, USA. Electronic address: Lina.chalak@utsouthwestern.edu.
² Department of Women's and Children's Health, Uppsala University, Division of Neonatology, Uppsala University Hospital, Sweden. Electronic address: lena.westas@kbh.uu.se.
³ Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine; 750 Welch Road, Suite 315, Palo Alto, CA, 94304, USA. Electronic address: soniab1@stanford.edu.
⁴ Department of Neurology and Pediatrics, George Washington University School of Medicine and Health Sciences, Children's National Hospital Division of Neurophysiology, Epilepsy and Critical Care, 111 Michigan Ave NW, West Wing, 4th Floor, Washington DC, 20010-2970, USA. Electronic address: TTsuchid@childrensnational.org.
⁵ Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine; 750 Welch Road, Suite 315, Palo Alto, CA, 94304, USA. Electronic address: vchock@stanford.edu.
⁶ Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, CWN#418, Boston, MA, 02115, USA. Electronic address: mel-dib@bwh.harvard.edu.
⁷ Department of Pediatrics, The George Washington University School of Medicine and Division of Neonatology, Children's National Hospital, Washington, USA. Electronic address: anguyenm@childrensnational.org.
⁸ Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain; University of Barcelona, Barcelona, Spain; NeNe Foundation, Madrid, Spain; Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain. Electronic address: alfredoalix@gmail.com.

Abstract

Several bedside and laboratory neuromonitoring tools are currently used in neonatal encephalopathy (NE) to assess 1) brain function [amplitude-integrated electroencephalogram (aEEG) and EEG], 2) cerebral oxygenation delivery and consumption [near-infrared spectroscopy (NIRS)] and 3) blood and cerebrospinal fluid biomarkers. The aim of the review is to provide the role of neuromonitoring in understanding the development of brain injury in these newborns and better predict their long-term outcome. Simultaneous use of these monitoring modalities may improve our ability to provide meaningful prognostic information regarding ongoing treatments. Evidence will be summarized in this review for each of these modalities, by describing (1) the methods, (2) the clinical evidence in context of NE both before and with hypothermia, and (3) the research and future directions.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Asphyxia Neonatorum* / therapy
Brain / diagnostic imaging
Electroencephalography / methods
Humans
Hypothermia, Induced* / methods
Hypoxia-Ischemia, Brain*
Infant, Newborn
Spectroscopy, Near-Infrared / methods

Abstract

Publication types

MeSH terms

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