standardized protocol for MRS in HIE

[marco.angriman]

Dear colleagaeus!

I'm an Italian Child Neurologist with a special interest in newborn neurology and I work in strict collaboration with the regional NICU (Central Hospital of Bolzano).

We are searching to stabilize an evidence-based protocol for the neuroimaging evaluation of newborns with HIE (with or without hypotermic treatment).

Do You use a kind of protocol?

Do You use MRi and MRS (of basal ganglia?) Wich timing of the evaluation do You advise?

Thank You so much for Your answers!

Sincerely Yours

Marco Angriman

[aridema]

Hi dott Angriman,

I'm a neonatologist from Mantova (third level UTIN). We usuallly follow the guidelines by the Italian Society of Neonatology (SIN) for hypotermic treatment of HIE. I think you and your collegues know them. As to the MRI we perform the first during the first week of life (4-5 days after hypotermic treatment. The second during the first month of life (25-30 days after birth). I send you the link to the raccomandation. Unfortunately they are in Italian (for other collegues) but they are based on international evidences (TOBY trial, ICE-trial, NeonEURO Network, Vermont Oxford Network).

http://www.neonatologia.it/lineeguida

arianna de martino

[Stefan Johansson]

This is the Karolinska strategy: the clinical protocol advocates MRI with diffusion on all newborns with HIE grade 2 and 3. The current research protocol includes also MRspectroscopy.

From what my colleague said, this is the strategies used at UCL (Univers College London).

Ciao! Stefan

[marco.angriman]

This is the Karolinska strategy: the clinical protocol advocates MRI with diffusion on all newborns with HIE grade 2 and 3. The current research protocol includes also MRspectroscopy.

From what my colleague said, this is the strategies used at UCL (Univers College London).

Ciao! Stefan

Thank You for Your feedback! At the Karolinska do you have a specific timing (days after hypoxic event) for the MRI? Do you use a cut-off of 0,29 for the Lac/NAA peak?

Thank You!

Ciao!

Marco

[Stefan Johansson]

Timing, asap after the 72h hypothermia, generally between 7 and 14 days (postnatal age), Cut-off, don't know.

[marco.angriman]

Timing, asap after the 72h hypothermia, generally between 7 and 14 days (postnatal age), Cut-off, don't know.

Thank You so much!

Be well!

Marco