Differential effects of propofol anaesthesia across three amplitude-defined electroencephalographic states in sedated critically ill term neonates

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dc.catalogadoryvc
dc.contributor.authorBoncompte Lezaeta, Gonzalo Nicolas
dc.contributor.authorCortinez Fernández, Luis Ignacio
dc.contributor.authorToso Milos, Alberto Antonio
dc.contributor.authorGiordano Villatoro, Ady Iveth
dc.contributor.authorCruzat Riquelme, Francisco Javier
dc.contributor.authorFuentes, Ricardo
dc.contributor.authorPedemonte Trewhela, Juan Cristóbal
dc.contributor.authorContreras Ibacache, Víctor Eliseo
dc.contributor.authorBiggs Muñoz, Daniela Paola
dc.contributor.authorChiu, Esteban
dc.contributor.authorIbacache Figueroa, Mauricio Enrique
dc.date.accessioned2025-06-09T15:02:13Z
dc.date.available2025-06-09T15:02:13Z
dc.date.issued2025
dc.description.abstractThe developing neonatal brain displays different electroencephalographic (EEG) responses to GABAergic anaesthetics than adults. Evidence suggests the importance of isoelectric-like activity patterns. However, markers of hypnotic depth are currently lacking for this population. OBJECTIVE To explore potential EEG markers of propofol-induced hypnosis in sedated critically ill term neonates. DESIGN Observational exploratory cohort study. PATIENTS Twenty critically ill term neonates (postmenstrual age 37 to 44 weeks) undergoing intensive care and requiring anaesthesia for noncardiac surgery. Patients with perinatal asphyxia, neurological pathology, brain malformations and metabolic or haemodynamic instability were excluded. INTERVENTION(S) Frontal EEG (Sedline) was recorded before induction and during a 20-min continuous rate propofol infusion. MAIN OUTCOME MEASURES Depending on peak amplitude, segmented EEG signals (1 s epochs) were classified as either isoelectric (<10 μV), low-voltage 10 to 25 μV), or high-voltage (>25 μV). Propofol effects were evaluated in terms of time occupancy and spectral properties within these EEG states. Correlations between clinical variables and EEG states were explored. RESULTS The EEGs of 17 neonates were analysed. Most showed periods of low-voltage (16/17, 94%) and isoelectric states (2/17, 70.5%) before anaesthesia. The time spent in these EEG states increased significantly during propofol infusion; 17/17 (100%), P < 0.001 and 16/17 (94.1%), P = 0.016, respectively. Propofol increased the mean [95% confidence interval (CI)] time spent in the isoelectric state per patient: 12.4 (3.3 to 21.5)% versus 28.6 (14.4 to 42.8)%, P < 0.002. A reduced spectral power was observed across all frequency bands during low-voltage states (all P < 0.026). Gestational age was negatively correlated with time in the isoelectric state; rho, 95% CI, −0.539 (−0.11 to −0.87), P = 0.031. CONCLUSION Our results show that isoelectric periods are common before anaesthesia in our studied population and more frequent in patients born at earlier gestational ages. The data suggest that propofol anaesthesia increases isoelectric EEG states while also reducing the spectral power, specifically during low-voltage EEG states. Potentially, both of these EEG changes could be biomarkers of neonatal hypnosis depth in this particular critically ill subpopulation. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04904965.
dc.format.extent10 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1097/eja.0000000000002208
dc.identifier.eissn0265-0215
dc.identifier.urihttp://dx.doi.org/10.1097/eja.0000000000002208
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104615
dc.information.autorucEscuela de Medicina; Boncompte Lezaeta, Gonzalo Nicolas; S/I; 217651
dc.information.autorucEscuela de Medicina; Cortinez Fernández, Luis Ignacio; 0000-0001-8544-8768; 79356
dc.information.autorucEscuela de Medicina; Toso Milos, Alberto Antonio; 0000-0002-3809-2567; 238020
dc.information.autorucEscuela de Química; Giordano Villatoro, Ady Iveth; 0000-0002-1867-6848; 207712
dc.information.autorucEscuela de Medicina; Cruzat Riquelme, Francisco Javier; S/I; 179209
dc.information.autorucEscuela de Medicina; Pedemonte Trewhela, Juan Cristobal; 0000-0001-5729-065X; 119581
dc.information.autorucEscuela de Medicina; Contreras Ibacache, Víctor Eliseo; S/I; 101258
dc.information.autorucEscuela de Medicina; Biggs Muñoz, Daniela Paola; S/I; 194722
dc.information.autorucEscuela de Medicina; Ibacache Figueroa, Mauricio Enrique; S/I; 817
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherEuropean Society of Anaesthesiology and Intensive Care
dc.revistaEuropean Journal of Anaesthesiology
dc.rightsacceso restringido
dc.subject.ddc610
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDifferential effects of propofol anaesthesia across three amplitude-defined electroencephalographic states in sedated critically ill term neonates
dc.typeartículo
dc.volumen42
sipa.codpersvinculados217651
sipa.codpersvinculados79356
sipa.codpersvinculados238020
sipa.codpersvinculados207712
sipa.codpersvinculados179209
sipa.codpersvinculados119581
sipa.codpersvinculados101258
sipa.codpersvinculados194722
sipa.codpersvinculados817
sipa.trazabilidadORCID;2025-06-03
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