Category: Asphyxia

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…