706 - Amplitude-integrated Electroencephalogram (aEEG) Findings in Infants with Bronchopulmonary Dysplasia (BPD)

Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants who require oxygen supplementation at 36 weeks postmenstrual age (PMA). Infants with BPD have an increased risk for poor neurodevelopmental outcome. Previous studies have shown that normal neonatal sleep pattern plays an important role in neuronal development. Using aEEG monitoring, presence of sleep-wake cycle (SWC) has been shown to be an important marker of neurodevelopment. However, the assessment of neonatal SWC status in infants with BPD is still lacking. In this study, we used aEEG in infants with BPD to monitor the presence of SWC.  


Objective:

We hypothesized that infants with BPD have abnormal SWC detected by aEEG. 


Design/Methods:

This observational study was performed from August 2018 to November 2022 at Regional One Health NICU. Infants born < 32 weeks gestational age (GA) with diagnosis of BPD were recruited and informed consents from legal guardians or parents were obtained. Study was approved by the IRB. Infants’ demographics, clinically relevant information and blood gas results were documented. Bedside two-channel (C3-C4, P3-P4) aEEG with Olympic Brainz CFM (Natus) was applied. All aEEG were obtained for 18 to 24 hours while infants received routine care. All aEEGs were read using aEEG classification from the Department of Pediatric Newborn Medicine at Brigham and Women’s Hospital (www.phscpd.org/BWH Neonatal aEEG). The aEEG monitoring can detect background pattern (continuous, discontinuous, burst-suppression, low voltage, inactive, flat), cycling (no cycling, imminent cycling, established cycling) and seizures or status epilepticus. 


Results:

A total of 13 infants were enrolled. The mean birth weight and GA were 26 ± 2 weeks and 718 ± 190 grams, respectively. The average PMA when the first aEEG obtained was 37 ± 3 weeks at day of life 77 ± 28. All enrolled infants met the criteria for BPD with no other identifiable major medical conditions. At the time of aEEG monitoring, four infants were on invasive mechanical ventilator; five infants were on non-invasive ventilator, four infants were on oxygen via bi-nasal cannula. The blood gas had mean pH of 7.35 ± 0.03, pCO2 of 52 ± 9 mmHg, and base excess of 4 ± 3 (Table 1). All infants had a normal aEEG background pattern and a normal SWC. An example of an aEEG recording on one infant is shown on Figure 1.


Conclusion(s):

In this study, we found that infants with BPD have no identifiable SWC abnormalities on aEEG recording. We aim to enroll more infants with BPD for our study. We also plan to correlate the aEEG findings with the neurodevelopmental outcomes.