Influence of Intensive Care Unit Enlightenment on Premature Infants on Functional Brain Maturation Assessed by Amplitude-Integrated Electroencephalograph
Objective Amplitude-integrated electroencephalograph (aEEG) presents a valuable tool for functional brain maturation of preterm infants. However, the effect of enlightenment on functional brain maturation of premature infants has not been investigated. We aimed to do this with aEEG.
Study Design A total of 32 infants, 30 to 35 gestational weeks, were involved in the study. They were randomly distributed into three groups in which different lighting protocols were applied. In group 1, the infants' incubators were covered for 24 hours. In group 2, the infants' incubators were open for 24 hours. In group 3, the infants' incubators were covered for 12 hours and open for another 12 hours. The infants are evaluated with aEEG recordings done on the 3rd (first measurement) and 10th days (second measurement) along with the Burdjalov scoring. Analysis of aEEG recordings was performed, based on sleep–wake cycles (SWCs), upper and lower margin amplitudes, narrowband and broadband of SWC, and bandwidth of SWC.
Results At first, the narrowband lower amplitudes in group 1 were higher than those of the other groups (p = 0.042), but the difference was not significant in the second measurement (p = 0.110). The Burdjalov scores were higher in group 1 and group 3 on 10th day, though not statistically significant (p = 0.871). When the infants were re-evaluated according to the gestational weeks, the Burdjalov scores of the two groups less than 34 weeks (30–31 and 32–33 weeks) were similar, whereas 34 to 35 weeks were higher when compared with those of the two groups.
Conclusion The difference observed between groups in terms of narrowband lower amplitude in the first measurement may reflect the effect of intrauterine environment rather than enlightenment at the same gestational age because it was made on the third day. However, the fact that all groups have similar results on day 10 suggests that other factors in the intensive care setting may diminish the effect of enlightenment. Burdjalov scores are associated with maturation, and high scores found in the 34- to 35-week group suggest that the 34-week maturation might be a threshold for SWC and development in our group sample.
Eingereicht: 10. Mai 2019
Angenommen: 13. August 2019
Artikel online veröffentlicht:
04. November 2019
© 2019. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Mirmiran M, Baldwin RB, Ariagno RL. Circadian and sleep development in preterm infants occurs independently from the influences of environmental lighting. Pediatr Res 2003; 53 (06) 933-938
- 2 Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function monitoring: a new scoring system for the evaluation of brain maturation in neonates. Pediatrics 2003; 112 (04) 855-861
- 3 El-Dib M, Chang T, Tsuchida TN, Clancy RR. Amplitude-integrated electroencephalography in neonates. Pediatr Neurol 2009; 41 (05) 315-326
- 4 Kato T, Okumura A, Hayakawa F, Tsuji T, Natsume J, Watanabe K. Evaluation of brain maturation in pre-term infants using conventional and amplitude-integrated electroencephalograms. Clin Neurophysiol 2011; 122 (10) 1967-1972
- 5 Sadeh A, Acebo C. Clinical Review. The role of actigraphy in sleep medicine. Sleep Med Rev 2002; 6 (02) 113-124
- 6 Sadeh A. The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev 2011; 15 (04) 259-267
- 7 Werth J, Atallah L, Andriessen P, Long X, Zwartkruis-Pelgrim E, Aarts RM. Unobtrusive sleep state measurements in preterm infants-A review. Sleep Med Rev 2017; 32: 109-122
- 8 Zhang D, Liu Y, Hou X. et al. Reference values for amplitude-integrated EEGs in infants from preterm to 3.5 months of age. Pediatrics 2011; 127 (05) e1280-e1287
- 9 Hayakawa M, Okumura A, Hayakawa F. et al. Background electroencephalographic (EEG) activities of very preterm infants born at less than 27 weeks gestation: a study on the degree of continuity. Arch Dis Child Fetal Neonatal Ed 2001; 84 (03) F163-F167
- 10 Vesoulis ZA, Paul RA, Mitchell TJ, Wong C, Inder TE, Mathur AM. Normative amplitude-integrated EEG measures in preterm infants. J Perinatol 2015; 35 (06) 428-433
- 11 Bertelle V, Mabin D, Adrien J, Sizun J. Sleep of preterm neonates under developmental care or regular environmental conditions. Early Hum Dev 2005; 81 (07) 595-600
- 12 El-Dib M, Massaro AN, Glass P. et al. Early amplitude integrated electroencephalography and outcome of very low birth weight infants. Pediatr Int 2011; 53 (03) 315-321
- 13 Hellström-Westas L, Rosen I, de Vries LS, Greisen G. Amplitude-integrated EEG classification and interpretation in preterm and term infants. Neoreviews 2006; 7: 72-87
- 14 Parmelee Jr AH, Wenner WH, Akiyama Y, Schultz M, Stern E. Sleep states in premature infants. Dev Med Child Neurol 1967; 9 (01) 70-77
- 15 Cui H, Ding Y, Yu Y, Yang L. Changes of amplitude integration electroencephalogram (aEEG) in different maturity preterm infant. Childs Nerv Syst 2013; 29 (07) 1169-1176
- 16 Bonan KC, Pimentel Filho JdaC, Tristão RM, Jesus JA, Campos Junior D. Sleep deprivation, pain and prematurity: a review study. Arq Neuropsiquiatr 2015; 73 (02) 147-154
- 17 Sung M, Adamson TM, Horne RS. Validation of actigraphy for determining sleep and wake in preterm infants. Acta Paediatr 2009; 98 (01) 52-57