Cerebral Function Monitoring in Premature Infants

• First aEEG within 72 hours of age [ Time Frame: < 72 hours of age ] [ Designated as safety issue: No ]
  

• Time required by research personnel to conduct study activities [ Time Frame: Birth to 36 weeks post menstrual age ] [ Designated as safety issue: No ]
  
• Serious adverse events [ Time Frame: < 72 hours of age until 36 weeks post menstrual age ] [ Designated as safety issue: Yes ]
  
• Agreement between aEEG recordings and clinical events including: seizures, cardiopulmonary resuscitation, surfactant administration, suctioning, and intubation [ Time Frame: < 72 hours of age until 36 weeks post menstrual age ] [ Designated as safety issue: No ]
  
• Weekly aEEG until infant is 36 weeks post menstrual age [ Time Frame: < 72 hours of age until 36 weeks post menstrual age ] [ Designated as safety issue: No ]
  

Few techniques exist to permit early and accurate prognosis of brain injury in newborns. Cranial ultrasound and magnetic resonance imaging (MRI) have been used to detect structural abnormalities which may be useful in predicting neuromotor and neurocognitive deficits. However, up to 30% of extremely low birth weight infants with normal ultrasounds have adverse outcomes, and MRI is not feasible when an infant is critically ill. Amplitude-integrated electroencephalogram (aEEG) is a non-invasive, bedside instrument which allows real-time monitoring of brain function and may provide additional information for predicting outcomes in extremely premature infants.

This observational study will enroll 85-100 infants between 401-1,000 grams birth weight OR between 23 0/7 and 28 6/7 weeks gestational age born at the 7 participating NICHD Neonatal Research Network sites. Eligible infants will undergo an aEEG recording in the first 72 hours of life, a second aEEG recording between 72-168 hours of life, and weekly thereafter up to 36 weeks post-menstrual age.

The study tests the feasibility of enrolling subjects and obtaining the required aEEG recordings. The information gathered will provide a framework for the design of a potential prospective, observational, multi-center study for prediction of death or neurodevelopmental impairment by 18-22 months of age.