Experiences of Parents Whose Newborns Undergo Hypothermia Treatment Following Perinatal Asphyxia

Nassef, Sari Kokkonen; Blennow, Mats; Jirwe, Maria

doi:10.1111/j.1552-6909.2012.01429.x

Cited by 34 publications

(46 citation statements)

References 28 publications

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“…The key messages that emerged from the survey were the need for consistency in Despite the different set of challenges, many aspects that emerged in our study of perception of HT are consistent with parental perceptions of having a baby admitted in the NICU for other indications [2,3,6,11,14]. Heringhaus et al [10] and Nassef et al [11] identified "emotional landscapes", which included vulnerability, sadness, guilt, feeling that the treatment was not natural, hope, despair, powerlessness, and gratefulness.…”

Section: Discussionmentioning

confidence: 63%

“…These could be related to natural tendency to reduce or avoid inner conflict. [25] Related sentiments (in form of 'rebirth' following rewarming with baby appearing more 'life like') have been described by Nassef [11] and religion and spirituality have been strongly associated with a host of positive outcomes, including enhanced quality of life. [25] …”

Section: Discussionmentioning

confidence: 99%

“…Heringhaus et al [10] and Nassef et al [11] identified "emotional landscapes", which included vulnerability, sadness, guilt, feeling that the treatment was not natural, hope, despair, powerlessness, and gratefulness. In both studies, anxieties about the results from the brain MRI and the uncertainties about long term outcomes following neonatal encephalopathy and HT treatment were highlighted as areas contributing to parental stress and anxieties.…”

Section: Discussionmentioning

confidence: 99%

“…The few available studies suggest that bonding and attachment between parents and baby may be particularly affected by the nature of the intervention. [10,11] The effectiveness of communication between families faced with this condition and the medical teams and their coping mechanisms are also unknown.…”

Section: Main Papermentioning

confidence: 99%

See 3 more Smart Citations

Parental perceptions of hypothermia treatment for neonatal hypoxic-ischaemic encephalopathy

Thyagarajan

Baral

Gunda

et al. 2017

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Main Papermentioning

confidence: 99%

See 2 more Smart Citations

Parental perceptions of hypothermia treatment for neonatal hypoxic-ischaemic encephalopathy

Thyagarajan

Baral

Gunda

et al. 2017

The Journal of Maternal-Fetal & Neonatal Medicine

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“…All parents left the NICU with some degree of prognostic uncertainty, and they were unprepared for how stressful this situation could be for months to years afterward. Our findings build on previous descriptions of parental experience of hypothermia 14 and neonatal neurologic care. 15 We defined patterns of communication challenges experienced by parents, and these patterns highlight opportunities to more fully prepare families for the short-and longterm.…”

Section: Discussionmentioning

confidence: 94%

Communication Challenges in Neonatal Encephalopathy

et al. 2016

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Remote Monitoring for Seizures During Therapeutic Hypothermia in Neonates With Hypoxic-Ischemic Encephalopathy

Variane,

Dahlen,

Pietrobom

et al. 2023

JAMA Netw Open

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ImportanceNeonates with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH) frequently experience seizures, which are associated with adverse outcomes. Efforts to rapidly identify seizures and reduce seizure burden may positively change neurologic and neurodevelopmental outcomes.ObjectiveTo describe the onset, treatment, and evolution of seizures in a large cohort of newborns with HIE during TH assisted by a telehealth model and remote neuromonitoring approach.Design, Setting, and ParticipantsThis was a prospective, observational, multicenter cohort study performed between July 2017 and December 2021 in 32 hospitals in Brazil. Participants were newborns with HIE meeting eligibility criteria and receiving TH. Data were analyzed from November 2022 to April 2023.ExposureInfants with HIE receiving TH were remotely monitored with 3-channel amplitude-integrated electroencephalography (aEEG) including raw tracing and video imaging, and bedside clinicians received assistance from trained neonatologists and neurologists.Main Outcomes and MeasuresData on modified Sarnat examination, presence, timing and seizure type, aEEG background activity, sleep-wake cycling, and antiepileptic drugs used were collected. Descriptive statistical analysis was used with independent t test, χ2, Mann-Whitney test, and post hoc analyses applied for associations.ResultsA total of 872 cooled newborns were enrolled; the median (IQR) gestational age was 39 (38-40) weeks, 518 (59.4%) were male, and 59 (6.8%) were classified as having mild encephalopathy by modified Sarnat examination, 504 (57.8%) as moderate, and 180 (20.6%) as severe. Electrographic seizures were identified in 296 newborns (33.9%), being only electrographic in 213 (71.9%) and clinical followed by electroclinical uncoupling in 50 (16.9%). Early abnormal background activity had a significant association with seizures. Infants with flat trace had the highest rate of seizures (58 infants [68.2%]) and the greatest association with the incidence of seizures (odds ratio [OR], 12.90; 95% CI, 7.57-22.22) compared with continuous normal voltage. The absence of sleep-wake cycling was also associated with a higher occurrence of seizures (OR, 2.22; 95% CI, 1.67-2.96). Seizure onset was most frequent between 6 and 24 hours of life (181 infants [61.1%]); however, seizure occurred in 34 infants (11.5%) during rewarming. A single antiepileptic drug controlled seizures in 192 infants (64.9%). The first line antiepileptic drug was phenobarbital in 294 (99.3%).Conclusions and RelevanceIn this cohort study of newborns with HIE treated with TH, electrographic seizure activity occurred in 296 infants (33.9%) and was predominantly electrographic. Seizure control was obtained with a single antiepileptic drug in 192 infants (64.9%). These findings suggest neonatal neurocritical care can be delivered at remote limited resource hospitals due to innovations in technology and telehealth.

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Experiences of Parents Whose Newborns Undergo Hypothermia Treatment Following Perinatal Asphyxia

Cited by 34 publications

References 28 publications

Parental perceptions of hypothermia treatment for neonatal hypoxic-ischaemic encephalopathy

Parental perceptions of hypothermia treatment for neonatal hypoxic-ischaemic encephalopathy

Communication Challenges in Neonatal Encephalopathy

Remote Monitoring for Seizures During Therapeutic Hypothermia in Neonates With Hypoxic-Ischemic Encephalopathy

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