Hypoxic-ischaemic encephalopathy: Identifying newborns who will benefit from therapeutic hypothermia in developing countries

Coetzee, M

doi:10.7196/sajch.2018.v12i4.1539

Cited by 1 publication

(2 citation statements)

References 43 publications

(110 reference statements)

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“…Currently, there are no locally published guidelines for the implementation of TH in a resource-constrained South African context. 21 Local eligibility criteria for TH are based on the six largest published trials to date and include the following: (1) infants with a gestation of ‡36 weeks, aged <6 hours; (2) who have signs of possible intrapartum hypoxia-ischemia (Apgar of £5 at 10 minutes, or who require continued resuscitation at 10 minutes, or who have severe acidosis [pH <7/base deficit ‡16]); and (3) who have an abnormal neurological assessment (moderate and/or severe encephalopathy, or clinical seizures, or an abnormal amplitude-integrated electroencephalography). 21…”

Section: Settingmentioning

confidence: 99%

“…25 When using the HIE score 25 to determine eligibility for TH, tertiary institutions with more resources such as the setting in the present study, may choose a lower threshold. 21 Neonates with meningitis, and metabolic, or congenital disorders were excluded. Neonates with HIV-exposure were included as no evidence could be found that HIV-exposure influences feeding in the neonatal period.…”

Section: Participantsmentioning

confidence: 99%

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Oropharyngeal Dysphagia in Breastfeeding Neonates with Hypoxic-Ischemic Encephalopathy on Therapeutic Hypothermia

Krüger

Kritzinger

Pottas

2019

Breastfeeding Medicine

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Purpose: To identify symptoms of oropharyngeal dysphagia (OPD) in breastfeeding neonates with hypoxicischemic encephalopathy (HIE) on therapeutic hypothermia (TH). Early identification of feeding problems in neonates with HIE by speech-language therapists (SLTs) may prevent secondary complications of OPD such as aspiration pneumonia and death. Materials and Methods: Twenty-eight full-term neonates with HIE (mean chronological age = 4.5 days) and 30 healthy term controls were prospectively recruited for this case-control study. Participants with HIE (mild), diagnosed by pediatricians, received whole-body TH. Feeding was clinically evaluated by an SLT using the Preterm Infant Breastfeeding Behavior Scale. Results: Twenty-five neonates (89.2%) had at least one symptom of OPD. Falling asleep during feeding, noticeable oral secretions, coughing, and flaring nostrils were symptoms of OPD most frequently identified. The HIE group displayed limited arousal during breastfeeding and had less obvious rooting, shallower latching onto the breast, and more single sucks in comparison to term newborns. The HIE group had significantly more closed eyes and minimal movement during breastfeeding, while controls showed the quiet-alert state ideal for breastfeeding. Conclusions: OPD was identified in the majority of infants with HIE. Underlying the appearance of an inactive neonate with HIE may be OPD that could be overlooked if not investigated. Interprofessional collaboration between SLTs, pediatricians and nurses to determine feeding-readiness is imperative. SLTs may assist in decision-making to improve safety of breastfeeding in this population. This study contributes to the small body of research on early breastfeeding of neonates with HIE.

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Section: Settingmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Oropharyngeal Dysphagia in Breastfeeding Neonates with Hypoxic-Ischemic Encephalopathy on Therapeutic Hypothermia

Krüger

Kritzinger

Pottas

2019

Breastfeeding Medicine

View full text Add to dashboard Cite

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Hypoxic-ischaemic encephalopathy: Identifying newborns who will benefit from therapeutic hypothermia in developing countries

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 1 publication

References 43 publications

Oropharyngeal Dysphagia in Breastfeeding Neonates with Hypoxic-Ischemic Encephalopathy on Therapeutic Hypothermia

Oropharyngeal Dysphagia in Breastfeeding Neonates with Hypoxic-Ischemic Encephalopathy on Therapeutic Hypothermia

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