Category: Asphyxia

MRI score to predict poor outcome after perinatal asphyxia

Investigators from the Netherlands and Sweden developed a scoring system for brain injury using MRI images (including diffusion weighted imaging) from neonates 36 weeks gestation or greater with hypoxic ischemic encephalopathy treated with total body hypothermia. The scoring system allocated…

The Apgar Score

A recent statement by the AAP and ACOG emphasizes the following about the Apgar score: It does not predict mortality or neurologic outcome in an individual infant. It alone should not be used to diagnose asphyxia – it is not…

EEG characteristics that predict outcome in HIE

A systematic review of studies in term neonates with hypoxic-ischemic encephalopathy assessed the diagnostic accuracy of background features of the EEG in identifying future neurodevelopmental outcome. Data were extracted from 31 eligible studies and meta-analyzed. Definitions for burst suppression, low…

Cooling for HIE – longer and deeper is not better

A randomized factorial-design trial from the Neonatal Research Network compared the effects of cooling babies with HIE to lower levels than ¬†usual (32 degrees C instead of 33.5 degrees C) and for longer than usual (120 hours instead of 72…

Long-term outcomes of total body hypothermia

The Total Body Hypothermia for Neonatal Encephalopathy (TOBY) randomized trial previously showed beneficial effects with therapeutic hypothermia at 18 months follow-up. The infants in these trial were followed until 6 – 7 years of age. Infants undergoing hypothermia treatment were…

Prognostic tests in HIE

A systematic review of prognostic tests in term infants with hypoxic ischemic encephalopathy included 29 studies of 13 different tests to predict long-term neurologic sequelae or death. Amplitude-integrated EEG and visual evoked potentials had the best sensitivity and specificity (around…

Long-term outcomes after whole-body hypothermia

Outcomes were assessed at 6 – 7 years. There was no significant difference in the composite outcome of death or IQ < 70. Death rates were lower with hypothermia and disability rates were not increased in survivors. Childhood outcomes after…