Neurological Disorders

Hello. Is there a guideline for asphexia in your hospital ?Is there a form for collect information your asphexia patients there?

Magnesium sulfate, given to mothers in preterm labour, has been suggested to improve neurological outcomes for preterm infants. However, ,&do=embed' frameborder='0' data-embedContent> long term follow-up studies has not been confirmative. Similar to one of the major publications in 2003 (in JAMA), principally showing trend towards better short term outcomes, those did not find associations with statistical significance, although absolute numbers of outcome events were more common among infants given placebo. In other words one could interpret these findings in two ways: 1. statistical power may have been too low to detect differences 2. the non-signific…

Dear mr\mrs We contact you because we are parents of asphyxiated newborn named Sára. She was resuscitated at birth (pH 6,6 Lactate 20) and she had treatment with terapeutic hypotermia for 72 hours. Now she has acute and subacute changes (thalamus, capsula interna, corticospinal tract, periventricular and cortical P-F-O bilateral) on MRI. We are hospitalized on Neonatology department Childrens hospital Bratislava,Slovakia). We would like to ask you if you now about some terapeutic trials which could help our daughter. We are grateful for every advice or option which could improve the condition our daughter. She was born 24.03.2014 Thank you very much for your …

Hi Netter, I had couple of patients (27 and 29 weekers) who have had grade III IVH in the first week of life, they had roller coaster course, where they had severe RDS, ventilated, received surfactant therapy, and clinically septic (septic shock). They have developed BPD (moderate - severe) and healthcare associated BSI down the road. we were following IVH-III with serial cranial ultrasound, and it was showing evidence of progressive ventricular dilatation till the stage that pediatric neurosurgeon was involved. At 7- 8 weeks of PMA everything disappeared totally. How frequent did you witnessed such a scenario? Regards

It would be nice to find out practices around the world regarding Head Cooling / Total Body Cooling for Birth Asphyxia. I have added a poll for this post. As for us, we do have the Olympus Head cooling apparatus but use it rarely. Maybe it is because we (the doctors and nurses ) are not comfortable with it. Seems to be related more to initial resistance while adopting a new technology rather than the equipment itself...which is remarkably simple to use.

Prophylactic treatment with indomethacin was shown to reduce the risk of severe IVH in the 1990s. (http://www.ncbi.nlm.nih.gov/pubmed/8134206) However, follow-up studies later showed that indomethacin prophylaxis did not improve mortality or neurodevelopmental outcomes. These findings are summarized in a Cochrane review from 2010. (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000174.pub2/abstract) The 99nicu Poll for June and July is about such NSAID prophylaxis and whether you have and/or still use it.

Hi Netters, I would like to explore the head cooling criteria. the criteria of the three largiest clinical trial of hypothermia are basically evidence of fetal acidemia, low apgar scores, the need for active resuscitation and clinical signs of encephalopathy +/- CFM monitoring. Although we are following these criteria but we may miss cases of moderate HIE. for example there is an evidence of perinatal sentinle event, cord pH 7.0 and BE -12, Apgar scores 6 & 8 @ 1 and 5 minutes. no active resuscitation required but at 10 hours of age the baby developed clinical seizure ( we missed the theraputic window for head cooling) and the work up R/O the common causes of seizurs.…

What is evidence based recommendation in treating large SDH/EDH/ICH in a new born ? Surgical or medical? comparision of results? thanks

Check this link : http://www.nemo-europe.com/

In a case with with stage 2 { moderate } Hypoxic ischemic encephalopathy (HIE) and seizures in 1 st day of life controlled by Phenobarbital , Phenytion and Midazolam. How and when should these drugs be withdrawed? ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ Mohamad Ismail neonatology resident Mansoura Egypt