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Front. Neurol. | doi: 10.3389/fneur.2018.00087

Investigation of EEG activity compared with mean arterial blood pressure in extremely preterm infants

  • 1Paediatrics, Barts Health NHS Trust, United Kingdom
  • 2Centre for Genomics and Child Health, Queen Mary University of London, United Kingdom
  • 3School of Computer Science and Mathematics, Kingston University, United Kingdom
  • 4Centre for Environmental and Preventive Medicine, Queen Mary University of London, United Kingdom
  • 5Centre for Neuroscience and Trauma, Queen Mary University of London, United Kingdom

Background: Cerebral electrical activity in extremely preterm infants is affected by various factors including blood gas and circulatory parameters.

Objective: To investigate whether continuously measured invasive mean arterial blood pressure (BP) is associated with electroencephalographic (EEG) discontinuity in extremely preterm infants.

Study design: This prospective observational study examined 51 newborn infants born <29 weeks gestation in the first three days after birth. A single channel of raw EEG was used to quantify discontinuity. Mean BP was acquired using continuous invasive measurement and Doppler ultrasound was used to measure left ventricular output (LVO) and common carotid artery blood flow (CCAF).

Results: Median gestation and birthweight were 25.6 weeks and 760 grams respectively. Mean discontinuity reduced significantly between day 1 and 3. EEG discontinuity was significantly related to gestation, pH and BP. LVO and CCAF were not associated with EEG discontinuity.

Conclusions: Continuously measured invasive mean arterial BP was found to have a negative relationship with EEG discontinuity; increasing BP was associated with lower EEG discontinuity. This did not appear to be mediated by surrogates of systemic or cerebral blood flow. Infants receiving inotropic support had significantly increased EEG discontinuity on the first day after birth.

Keywords: EEG, Electroencephalogram, EEG continuity, Blood Pressure, preterm infant

Received: 27 Nov 2017; Accepted: 07 Feb 2018.

Edited by:

Stephane V. Sizonenko, Geneva University Hospitals (HUG), Switzerland

Reviewed by:

Gunnar Naulaers, KU Leuven, Belgium
Sarah A. Kelley, Johns Hopkins University, United States  

Copyright: © 2018 Pereira, Kempley, Wertheim, Sinha, Morris and Shah. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Divyen K. Shah, Barts Health NHS Trust, Paediatrics, Royal London Hospital, Whitechapel, London, E1 1BB, United Kingdom, d.shah@qmul.ac.uk