363 - Effect of Chronic Hypercapnia on Sleep Wake Cycles (SWC) on Amplitude-integrated Electroencephalogram (aEEG) in Infants with Bronchopulmonary Dysplasia

Poster Number: 363
Publication Number: 363.440

Divya Rana, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States; Rohan N. Vaidya, UTHSC, Memphis, TN, United States; Leann Pollard, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States; Massroor Pourcyrous, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States

Background: Premature infants born at less than 32 weeks of gestational age are at risk for developing bronchopulmonary dysplasia (BPD). Several ventilation and pharmacological therapies are purported to improve the outcome of BPD but not a single or combination of therapy has been shown to reduce or improve the respiratory outcome. These infants will have fluctuating and more often higher concentrations of pCO2 (partial pressure of carbon dioxide) levels on routing blood gas monitoring. Changes in pCO2 levels are known to affect the cerebral blood flow.

Objective: We hypothesized that premature infants with bronchopulmonary dysplasia will have abnormal amplitude-integrated encephalogram (aEEG) due to chronic hypercapnia.

Design/Methods: This is a pilot prospective observational study from August 2018 through to December 2018. Premature Infants born < 32 weeks with diagnosis of BPD were recruited. Infant demographics, growth parameter, blood gas results and medications use were recorded. After obtaining informed consent from legal guardian or parent, a bedside two channel, C3-C4 and P3-P4 amplitude-integrated encephalogram (aEEG) using Olympic Brainz CFM (Natus) were applied. All aEEG recordings were completed for 24 hours while receiving routine care and aEEG was repeated weekly till discharge to home or transfer another facility.

Results: In this pilot study we enrolled 7 infants. The mean birth weight and gestational age were 26±2 weeks and 651± 141 grams, respectively. Each study infant received 1-3 aEEG recording. The average corrected age at first aEEG was 38±2 weeks. Three infants were on invasive ventilation while two were on non-invasive ventilation modes. The mean pH was 7.34±0.07 and pCO2 of 58±11 mm of hg and base excess of 4±3. All seven infants had a normal aEEG which remained the same with the repeated aEEG monitoring. All infants demonstrated age appropriate SWC on bedside aEEGConclusion(s): Extreme premature Infants with diagnosis of BPD will have normal aEEG despite hypercapnia.
Study Subject aEEG Tracing with Continuous Normal Voltage and Mature Sleep Wake Cycles