The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome

Thompson, Clare; Puterman, A.; Linley, L L; Hann, F. M.; Elst, C W van der; Molteno, Christopher D.; Malan, Arnaud G.

doi:10.1111/j.1651-2227.1997.tb08581.x

Cited by 354 publications

(277 citation statements)

References 13 publications

Supporting

Mentioning

261

Contrasting

Unclassified

Order By: Relevance

“…The most widely quoted is the Sarnat score, which is based on changes in EEG characteristics in addition to standard clinical features. 15 Simpler grading or scoring systems, based on the Sarnat score, are commonly used, such as a modified Sarnat encephalopathy score, 16 the Thompson score, 17 and others. 18 Problems with these scoring systems include difficulties in reliably measuring some clinical parameters soon after birth (e.g.…”

Section: Clinical Assessment Of Hypoxic-ischaemic Encephalopathymentioning

confidence: 99%

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Merchant

Azzopardi

2015

Develop Med Child Neuro

View full text Add to dashboard Cite

Hypoxic–ischaemic encephalopathy (HIE) is a leading cause of acquired neonatal brain injury. Assessment of the severity of cerebral injury and likely neurological outcome in infants with HIE is important for determining management and prognosis, for counselling parents, and for selection for neuroprotective trials. The condition of the infant at birth, the severity of HIE, neurophysiological tests, including amplitude‐integrated electroencephalography (aEEG), biochemical markers, and neuroimaging have been used to assess prognosis and predict long‐term outcome. The predictive accuracy of these indicators in the early postnatal period is modest. Neurophysiological assessment seems to be most helpful during the first 24 to 48 hours after birth whilst magnetic resonance imaging (MRI) seems most informative later. Several biochemical markers, including serum S100β and neuron‐specific enolase (NSE), are also associated with HIE but their levels depend on the timing of sampling and their prognostic value is uncertain. Comprehensive neurophysiological assessment and neuroimaging may be limited to specialist centres. Therapeutic hypothermia is now standard care in infants with moderate to severe HIE so it is important to examine the influence of hypothermia on the assessment of prognosis in these infants.

show abstract

Section: Clinical Assessment Of Hypoxic-ischaemic Encephalopathymentioning

confidence: 99%

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Merchant

Azzopardi

2015

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…A similar scoring system has also been used by other investigators in other parts of the world for predicting neurodevelopmental outcome in HIE patients. 22 We understand the limitation of these clinical tools for evaluating the acute neurological outcome of patients. A long-term neurological outcome follow-up study of our enrolled patients will significantly enhance the value of this study.…”

mentioning

confidence: 99%

Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit

Zl¹,

et al. 2006

J Perinatol

114

View full text Add to dashboard Cite

Objective: The objective of this study was to determine the efficacy of mild hypothermia via selective head cooling as a neuroprotective therapy in term infants with perinatal asphyxia.Study design: Full-term newborns who had 5 min Apgar scores <6, first arterial blood gas pH<7.10 or BD>15 mEq/l, and with the clinical signs of encephalopathy were enrolled within 6 h after birth. Patients were randomized to receive mild hypothermia treatment via selective head cooling for a total of 72 h or receive routine treatment as a control. Brain hypoxic-ischemic injury was quantified based on the head computed tomographic scan (CT scan) at postnatal age 5-7 days and a Neonatal Behavioral Neurological Assessment (NBNA) score at 7-10 days of life.Results: A total of 58 patients (30 hypothermia, 28 control) completed the study. Hypothermia was well tolerated in this study and attenuated the hypoxic-ischemic brain injury due to perinatal asphyxia. Head CT scan demonstrated moderate to severe hypoxic-ischemic changes in only 4/30 cases from the hypothermic group. In contrast, 18/28 cases in the control group showed moderate to severe hypoxic-ischemic changes (w 2 ¼ 15.97, P<0.01). Brain hypothermia also significantly improved the NBNA score (32±2 in the hypothermic group vs 28±3 in the control group, P<0.01). Conclusions:Our results suggest that selective head cooling may be used as a neuroprotective therapy in term neonates with perinatal asphyxia. A long-term follow-up study is needed to further validate the results of this study.

show abstract

“…18,35,36 The high prevalence rates and early timing of morbidity symptoms for infants with NRD and NE emphasize the need for skilled birth attendance and early postnatal visits (Ͻ72 hours) in communities with high rates of home births. Thompson et al 40 similarly found that neurologic symptoms peaked among infants with NE on days 3 to 4. Furthermore, there is a dearth of information regarding longer-term morbidity and outcomes related to intrapartum events in low-income, community settings.…”

Section: Figurementioning

confidence: 88%

Incidence of and Risk Factors for Neonatal Respiratory Depression and Encephalopathy in Rural Sarlahi, Nepal

2011

PEDIATRICS

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT:Intrapartum-related (IPR) hypoxic events ("birth asphyxia") result in an estimated 2 million fetal/neonatal deaths and 1 million impaired survivors each year, primarily in low-and middle-income countries. Limited data on the incidence, risk factors, and morbidity associated with IPR events are available from these settings. WHAT THIS STUDY ADDS:In Sarlahi, 20% of newborns experienced respiratory depression at birth; the incidence of neonatal encephalopathy was 28 to 33 cases per 1000 live births. The case fatality rate for IPR neonatal encephalopathy was 46%. Long-term implications for survivors are poorly understood. abstract OBJECTIVES: To characterize the incidence of, risk factors for, and neonatal morbidity and mortality associated with respiratory depression at birth and neonatal encephalopathy (NE) among term infants in a developing country. METHODS:Data were collected prospectively in 2002-2006 during a community-based trial that enrolled 23 662 newborns in rural Nepal and evaluated the impact of umbilical-cord and skin cleansing on neonatal morbidity and mortality rates. Respiratory depression at birth and NE were defined on the basis of symptoms from maternal reports and study-worker observations during home visits. RESULTS:Respiratory depression at birth was reported for 19.7% of live births, and 79% of cases involved term infants without congenital anomalies. Among newborns with probable intrapartum-related respiratory depression (N ϭ 3465), 112 (3%) died before their first home visit (presumed severe NE), and 178 (5%) eventually developed symptoms of NE. Overall, 629 term infants developed NE (28.1 cases per 1000 live births); 2% of cases were associated with congenital anomalies, 25% with infections, and 28% with a potential intrapartum event. The incidence of intrapartum-related NE was 13.0 cases per 1000 live births; the neonatal case fatality rate was 46%. Infants with NE more frequently experienced birth complications and were male, of multiple gestation, or born to nulliparous mothers. CONCLUSIONS:In Sarlahi, the incidence of neonatal respiratory depression and NE, associated neonatal case fatality, and morbidity prevalence are high. Action is required to increase coverage of skilled obstetric/neonatal care in this setting and to evaluate long-term impairments. Pediatrics 2011;128:e915-e924

show abstract

The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome

Cited by 354 publications

References 13 publications

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit

Incidence of and Risk Factors for Neonatal Respiratory Depression and Encephalopathy in Rural Sarlahi, Nepal

Contact Info

Product

Resources

About