Asphyxia from the eyes of the neonatologist

Paolo Gancia, Giulia Pomero, Antonio Delogu, Cristina Dalmazzo

Abstract


The perinatal asphyxia occurs at a frequency of 4-6‰ in developed countries The hypoxic-ischemic encephalopathy (HIE) has an incidence of 0.5-2‰, and is a frequent cause of death and severe disability.

Cerebral hypothermia is a well-established therapy of HIE, and its benefits have been described by systematic reviews and meta-analyses of numerous controlled clinical trials.

Authors describe their experience in implementation of cerebral hypotermia in a Neonatal Intensive Care Unit, the creation of a network to perform neurophysiologic study of asphyxiated infants ≥ 35 weeks gestation, potential hypothermia candidates. Neurodevelopmental prognosis of HIE infants is of paramount importance for parents. To improve the quality of prognosis and communication with the parents, two studies have been undertaken. First, EEG and magnetic resonance imaging (MRI) relationships analysis showed that the severity of the background EEG is associated with the severity and location of MRI lesion patterns in infants treated with hypothermia because of HIE. The second study aims to elucidate the relationships between MRI patterns and neurodevelopmental assessment by Griffiths scales. We found that neuroimaging findings correlate significantly with overall neurodevelopmental assessment at 12 and 24 months of life; in particular, this correlation is significant for the loco-motor and psycho-social sides.

These instrumental data, with the EEG evaluation and clinical data, allow the neonatologist to predict quite precisely the neurological outcome of an infant.

 

Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy) · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology

Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou



Keywords


perinatal asphyxia; hypoxic-ischemic encephalopathy; brain cooling; amplitude integrated EEG monitoring; neonatal emergency transport service; magnetic resonance imaging patterns

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