Integrating Neurocritical Care Approaches into Neonatology: Should All Infants Be Treated Equitably?

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2015 Aug 7

PMID 26248128

Citations 1

Authors

P C Mann

S M Gospe

K J Steinman

B S Wilfond

Affiliations

Soon will be listed here.

Abstract

To improve the neurologic outcomes for infants with brain injury, neonatal providers are increasingly implementing neurocritical care approaches into clinical practice. Term infants with brain injury have been principal beneficiaries of neurologically-integrated care models to date, as evidenced by the widespread adoption of therapeutic hypothermia protocols for hypoxic-ischemic encephalopathy. Innovative therapeutic and diagnostic support for very low birth weight infants with brain injury has lagged behind. Given that concern for significant future neurodevelopmental impairment can lead to decisions to withdraw life supportive care at any gestational age, providing families with accurate prognostic information is essential for all infants. Current variable application of multidisciplinary neurocritical care approaches to infants at different gestational ages may be ethically problematic and reflect distinct perceptions of brain injury for infants born extremely premature.

Citing Articles

From Neonatal Intensive Care to Neurocritical Care: Is It Still a Mirage? The Sicilian Multicenter Project.

Falsaperla R, Mauceri L, Motta M, Piro E, DAngelo G, Gitto E Crit Care Res Pract. 2021; 2021:1782406.

PMID: 34426771 PMC: 8380151. DOI: 10.1155/2021/1782406.

References

Ment L, Bada H, Barnes P, Grant P, Hirtz D, Papile L . Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2002; 58(12):1726-38. DOI: 10.1212/wnl.58.12.1726. View

Zanelli S, Naylor M, Dobbins N, Quigg M, Goodkin H, Matsumoto J . Implementation of a 'Hypothermia for HIE' program: 2-year experience in a single NICU. J Perinatol. 2007; 28(3):171-5. DOI: 10.1038/sj.jp.7211896. View

Cseko A, Bango M, Lakatos P, Kardasi J, Pusztai L, Szabo M . Accuracy of amplitude-integrated electroencephalography in the prediction of neurodevelopmental outcome in asphyxiated infants receiving hypothermia treatment. Acta Paediatr. 2013; 102(7):707-11. DOI: 10.1111/apa.12226. View

Patrizi S, Holmes G, Orzalesi M, Allemand F . Neonatal seizures: characteristics of EEG ictal activity in preterm and fullterm infants. Brain Dev. 2003; 25(6):427-37. DOI: 10.1016/s0387-7604(03)00031-7. View

Ancel P, Livinec F, Larroque B, Marret S, Arnaud C, Pierrat V . Cerebral palsy among very preterm children in relation to gestational age and neonatal ultrasound abnormalities: the EPIPAGE cohort study. Pediatrics. 2006; 117(3):828-35. DOI: 10.1542/peds.2005-0091. View

Mann P, Woodrum D, Wilfond B . Fuzzy images: Ethical implications of using routine neuroimaging in premature neonates to predict neurologic outcomes. J Pediatr. 2013; 163(2):587-92. DOI: 10.1016/j.jpeds.2013.03.055. View

Scher M, Aso K, Beggarly M, Hamid M, Steppe D, Painter M . Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae. Pediatrics. 1993; 91(1):128-34. View

Johnston M, Fatemi A, Wilson M, Northington F . Treatment advances in neonatal neuroprotection and neurointensive care. Lancet Neurol. 2011; 10(4):372-82. PMC: 3757153. DOI: 10.1016/S1474-4422(11)70016-3. View

Okumura A, Hayakawa F, Kato T, Itomi K, Maruyama K, Kubota T . Ictal electroencephalographic findings of neonatal seizures in preterm infants. Brain Dev. 2007; 30(4):261-8. DOI: 10.1016/j.braindev.2007.08.011. View

10.

Shalak L, Laptook A, Velaphi S, Perlman J . Amplitude-integrated electroencephalography coupled with an early neurologic examination enhances prediction of term infants at risk for persistent encephalopathy. Pediatrics. 2003; 111(2):351-7. DOI: 10.1542/peds.111.2.351. View

11.

Van Reempts P, Gortner L, Milligan D, Cuttini M, Petrou S, Agostino R . Characteristics of neonatal units that care for very preterm infants in Europe: results from the MOSAIC study. Pediatrics. 2007; 120(4):e815-25. DOI: 10.1542/peds.2006-3122. View

12.

Hellstrom-Westas L, Rosen I, SVENNINGSEN N . Predictive value of early continuous amplitude integrated EEG recordings on outcome after severe birth asphyxia in full term infants. Arch Dis Child Fetal Neonatal Ed. 1995; 72(1):F34-8. PMC: 2528413. DOI: 10.1136/fn.72.1.f34. View

13.

Laptook A, OShea T, Shankaran S, Bhaskar B . Adverse neurodevelopmental outcomes among extremely low birth weight infants with a normal head ultrasound: prevalence and antecedents. Pediatrics. 2005; 115(3):673-80. DOI: 10.1542/peds.2004-0667. View

14.

Wachtel E, Hendricks-Munoz K . Current management of the infant who presents with neonatal encephalopathy. Curr Probl Pediatr Adolesc Health Care. 2011; 41(5):132-53. DOI: 10.1016/j.cppeds.2010.12.002. View

15.

Schlapbach L, Aebischer M, Adams M, Natalucci G, Bonhoeffer J, Latzin P . Impact of sepsis on neurodevelopmental outcome in a Swiss National Cohort of extremely premature infants. Pediatrics. 2011; 128(2):e348-57. DOI: 10.1542/peds.2010-3338. View

16.

Nguyen The Tich S, dAllest A, Touzery de Villepin A, de Belliscize J, Walls-Esquivel E, Salefranque F . [Pathological patterns in neonatal EEG before 30 weeks of gestational age]. Neurophysiol Clin. 2007; 37(3):177-221. DOI: 10.1016/j.neucli.2007.06.004. View

17.

. Routine screening cranial ultrasound examinations for the prediction of long term neurodevelopmental outcomes in preterm infants. Paediatr Child Health. 2010; 6(1):39-52. PMC: 2804452. DOI: 10.1093/pch/6.1.39. View

18.

Phibbs C, Baker L, Caughey A, Danielsen B, Schmitt S, Phibbs R . Level and volume of neonatal intensive care and mortality in very-low-birth-weight infants. N Engl J Med. 2007; 356(21):2165-75. DOI: 10.1056/NEJMsa065029. View

19.

Thoresen M, Hellstrom-Westas L, Liu X, de Vries L . Effect of hypothermia on amplitude-integrated electroencephalogram in infants with asphyxia. Pediatrics. 2010; 126(1):e131-9. DOI: 10.1542/peds.2009-2938. View

20.

Shankaran S . Therapeutic hypothermia for neonatal encephalopathy. Curr Treat Options Neurol. 2012; 14(6):608-19. PMC: 3519960. DOI: 10.1007/s11940-012-0200-y. View