Neurological Disorders

Thanks to our latest page about Latest Research with the automated feed on PubMed, this AAP Clinical Report came on my radar about Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy. Great write-up about the background and evidence about HIE and hypothermia treatment. In the recommendation (last page!), AAP recommends 1) blood gas aligning with asphyxia and 2) moderate-severe HIE, before initiating hypotherma. Here in the Outer Rim (i.e. Sweden!), we have a more diverse #1 criteria in our national guideline, Apgar score ≤5 at 10 min, need of ongoing resusc beyond 10 min, and/or acidosis (pH <7.0 or BE <-16 first 60 min). We published about those so…

2 month old. Premature 32 week. Irritability after acellular pertussis. No daylight sleep (there is no problem in night sleep). What to do ? Paracetamol ? Dose ? Phenobarbital ? What must be our advice for later vaccines ?

What do you do for hipotony in one upper extremity ? Xray ? Wait and see ? Pyhsioterapy ? Neurology consultation ? Brain surgery consultation ?

What do you do for cephal hematoma ? Search for lineer fracture ? Xray ? Ultrasonography ?

This is a very interesting publication from the UK, about IVH rates in infants born <29 weeks from 2013 through 2019. Rates are increasing over time, findings along the lines of other studies showing that outcomes does not improve much despite all work we do to change things for the better Would be great to hear yout thoughts about the paper but also how you aim to reduce IVH risks / like IVH prevention tool kits etc https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828692

Do you have any protocol or bibliografy?¿? tanks a lot

The SafeBoosC-III trial is now out in NEJM (https://www.nejm.org/doi/full/10.1056/NEJMoa2207554) I know lots of effort has been put into this study, 70 NICUs in 17 countries included 1600 extremely preterm infants, randomised to either cerebral oximetry in the first 72 hours or usual care (without such monitoring). Primary endpoint was death or USG-diagnosed severe brain injury at 36 weeks. No differences found, the primary endpoint occured in 1/3 in both groups. How will this study impact your care?

Don’t miss this weeks seminar from the Newborn Brain Society on nutrition and the preterm brain. https://us02web.zoom.us/webinar/register/WN_k786xQyCR9udifW6RDYTjA You will also be able to watch it for a week on their webpage: https://newbornbrainsociety.org/media-library/

After reading this: https://rdcu.be/cqY8Y .. we decided to try for ourselves. It does work! Who uses ultrasound to guide lumbar puncture as well? Do you prefer to access out-of-plane or in-plane? Did you run into any unexpected difficulties? Have you identified any helpful landmarks?

We are doing. QI project regarding parental holding while being cooled. Do you allow and if so do you have a holding protocol?