Cerebral Function Monitoring In Neonatal Intensive Care Units

Amplitude-integrated electroencephalography (aEEG) is a method for continuous monitoring of brain activity that is increasingly used in the neonatal intensive care unit. aEEG is accessible by non-expert person, and offers continuous bedside cerebral function monitoring (CFM). In its simplest form, aEEG is a processed single-channel electroencephalogram that is filtered and time-compressed. Several classifications are currently in use to describe patient tracings, incorporating voltage criteria, pattern recognition, cyclicity, and the presence or absence of seizures. The main usage of the CFM currently is for monitoring term newborns after birth asphyxia. Another well-established indication for CFM is monitoring for seizure activity with an addition advantage of monitoring the treatment effect. Current evidences demonstrate that aEEG is useful to monitor cerebral background activity, diagnose and treat seizures and predict neurodevelopmental outcomes for newborns. Thus, the main advantages of this device are its simplicity for both application and interpreting on one hand and the possibility of continuous long-term monitoring with real time assessment of clinical events on the other. This review aims to explain the fundamentals behind aEEG and its clinical applications.