The Impact of Continuous Digital Video Electroencephalogram (CEEG) Introduction on the Use of Anti-Epileptic Drugs (AEDS) in Neonates with Hypoxic Ischemic Encephalopathy (HIE)
Bibliographic record
Abstract
Abstract BACKGROUND: Use of AEDs in neonates may disrupt neuronal development by synaptic re-organization and altering brain plasticity. Introduction of cEEG as part of neonatal neurocritical care long term monitoring (LTM) aims to improve seizure detection and control in neo-nates with HIE. OBJECTIVES: To assess the impact of cEEG on seizure detection and the use of AEDs in neonates with HIE DESIGN/METHODS: A retrospective cohort study of neonates admitted with HIE to a level III NICU two years before and after introduction of LTM in August 2013. The cEEGs were read remotely by a pediatric epileptologist. Before LTM, a 60 minute routine EEG (rEEG) was the standard practice. Primary outcome was the number of AEDs used. Secondary outcomes were AEDs used as maintenance and on discharge, and AEDs burden (total mg/kg used during hospital stay). HIE staging was based on modified Sarnat scoring system. Drug burden for each AED was calculated. Categorical variables were analysed using Chi-square test and continuous variables using student's t test. RESULTS: n=157 (total number of HIE patients); median gestation 40 weeks (IQR 38-40); 71 infants(45%) had LTM monitoring;103 infants(66%) were cooled. Baseline and clinical characteristics including disease severity and cooling were similar. In the pre LTM era, 12 of 52 (23%) infants with clinical seizures, only 12 had seizures by rEEG . Using cEEG, 17 out of 33 (52%) clinical seizures were confirmed by cEEG; 5/36(1%) had subclinical seizures compared to none before LTM. Detection of EEG seizures increased significantly with LTM (p 0.02). Discharge on any AEDs was less in the LTM group and the mean AEDs burden was reduced from 176 mg/kg in the pre LTM to 91 mg/kg in the post LTM group. CONCLUSION: Introduction of cEEG improved seizure detection and control; but decreased the overall use and burden of AEDs. p value <0.05 is denoted as *
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".