Nucleated red blood cells and early EEG: predicting Sarnat stage and two year outcome.

Hdl Handle:
http://hdl.handle.net/10147/206242
Title:
Nucleated red blood cells and early EEG: predicting Sarnat stage and two year outcome.
Authors:
Walsh, B H; Boylan, G B; Murray, D M
Affiliation:
Neonatal Brain Research Group, Cork University Maternity Hospital, Wilton, Cork, , Ireland. Bh.walsh@ucc.ie
Citation:
Early Hum Dev. 2011 May;87(5):335-9. Epub 2011 Feb 18.
Journal:
Early human development
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206242
DOI:
10.1016/j.earlhumdev.2011.01.041
PubMed ID:
21333469
Abstract:
AIMS: Hypoxic Ischaemic Encephalopathy (HIE) causes characteristic changes of the electroencephalogram (EEG), and a raised Nucleated Red Blood Cell (NRBC) count compared to controls. We wished to examine whether combining these markers could improve their ability to predict HIE severity in the first 24h. METHODS: Term infants with HIE were recruited. NRBC count and continuous multi-channel EEG were recorded within the first 24h. Neurological assessment was carried out at 24 months. A control population with NRBC counts in the first 24h was recruited. RESULTS: 44 infants with HIE and 43 control infants were recruited. Of the HIE population 39 completed a 2 year follow-up. The median NRBC count differed significantly between the controls and those with HIE (3/100 WBC [range of 0-11] vs 12.3/100 WBC [0-240]) (p<0.001). Within the HIE population the median NRBC count was significantly greater in infants with moderate/severe HIE than mild (16/100 WBC [range of 0-240] vs 8/100 WBC [1-23]) (p=0.016), and among infants with abnormal outcome compared to normal (21.3/100 WBC [1-239.8] vs 8.3/100 WBC [0-50])(p=0.03). The predictive ability of EEG changed with time post-delivery, therefore results are given at both 12 and 24h of age. At both time points the combined marker had a stronger correlation than EEG alone; with HIE severity (12h: r=0.661 vs r=0.622), (24h: r=0.645 vs r=0.598), and with outcome at 2 years (12h: r=0.756 vs r=0.652), (24h: r=0.802 vs r=0.746). CONCLUSION: Combining early EEG and NRBC count to predict HIE severity and neurological outcome, improved the predictive ability of either in isolation.
Language:
eng
MeSH:
Blood Cell Count; Child Development; Child, Preschool; Electroencephalography/methods; Erythroblasts/*pathology; Female; Follow-Up Studies; Humans; Hypoxia-Ischemia, Brain/*blood/*physiopathology; Infant, Newborn; Male; Neurologic Examination; Predictive Value of Tests; Prognosis; Sensitivity and Specificity
ISSN:
1872-6232 (Electronic); 0378-3782 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorWalsh, B Hen_GB
dc.contributor.authorBoylan, G Ben_GB
dc.contributor.authorMurray, D Men_GB
dc.date.accessioned2012-01-31T16:43:24Z-
dc.date.available2012-01-31T16:43:24Z-
dc.date.issued2012-01-31T16:43:24Z-
dc.identifier.citationEarly Hum Dev. 2011 May;87(5):335-9. Epub 2011 Feb 18.en_GB
dc.identifier.issn1872-6232 (Electronic)en_GB
dc.identifier.issn0378-3782 (Linking)en_GB
dc.identifier.pmid21333469en_GB
dc.identifier.doi10.1016/j.earlhumdev.2011.01.041en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206242-
dc.description.abstractAIMS: Hypoxic Ischaemic Encephalopathy (HIE) causes characteristic changes of the electroencephalogram (EEG), and a raised Nucleated Red Blood Cell (NRBC) count compared to controls. We wished to examine whether combining these markers could improve their ability to predict HIE severity in the first 24h. METHODS: Term infants with HIE were recruited. NRBC count and continuous multi-channel EEG were recorded within the first 24h. Neurological assessment was carried out at 24 months. A control population with NRBC counts in the first 24h was recruited. RESULTS: 44 infants with HIE and 43 control infants were recruited. Of the HIE population 39 completed a 2 year follow-up. The median NRBC count differed significantly between the controls and those with HIE (3/100 WBC [range of 0-11] vs 12.3/100 WBC [0-240]) (p<0.001). Within the HIE population the median NRBC count was significantly greater in infants with moderate/severe HIE than mild (16/100 WBC [range of 0-240] vs 8/100 WBC [1-23]) (p=0.016), and among infants with abnormal outcome compared to normal (21.3/100 WBC [1-239.8] vs 8.3/100 WBC [0-50])(p=0.03). The predictive ability of EEG changed with time post-delivery, therefore results are given at both 12 and 24h of age. At both time points the combined marker had a stronger correlation than EEG alone; with HIE severity (12h: r=0.661 vs r=0.622), (24h: r=0.645 vs r=0.598), and with outcome at 2 years (12h: r=0.756 vs r=0.652), (24h: r=0.802 vs r=0.746). CONCLUSION: Combining early EEG and NRBC count to predict HIE severity and neurological outcome, improved the predictive ability of either in isolation.en_GB
dc.language.isoengen_GB
dc.subject.meshBlood Cell Counten_GB
dc.subject.meshChild Developmenten_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshElectroencephalography/methodsen_GB
dc.subject.meshErythroblasts/*pathologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHypoxia-Ischemia, Brain/*blood/*physiopathologyen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshMaleen_GB
dc.subject.meshNeurologic Examinationen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshPrognosisen_GB
dc.subject.meshSensitivity and Specificityen_GB
dc.titleNucleated red blood cells and early EEG: predicting Sarnat stage and two year outcome.en_GB
dc.contributor.departmentNeonatal Brain Research Group, Cork University Maternity Hospital, Wilton, Cork, , Ireland. Bh.walsh@ucc.ieen_GB
dc.identifier.journalEarly human developmenten_GB
dc.description.provinceMunster-
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