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Neonatal Neurocritical care

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https://www.readbyqxmd.com/read/27663489/the-value-of-neonatal-neurocritical-care
#1
Margie A Ream
No abstract text is available yet for this article.
August 28, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27647155/implementation-of-a-neurocritical-care-program-improved-seizure-detection-and-decreased-antiseizure-medication-at-discharge-in-neonates-with-hypoxic-ischemic-encephalopathy
#2
Rani Ameena Bashir, Liza Espinoza, Sakeer Vayalthrikkovil, Jeffrey Buchhalter, Leigh Irvine, Luis Bello-Espinosa, Khorshid Mohammad
BACKGROUND: We report the impact of implementing continuous video electroencephalography monitoring for neonates with hypoxic-ischemic encephalopathy via a protocol in the context of neonatal neuro-critical care program. METHODS: Neonates with hypoxic-ischemic encephalopathy were studied retrospectively two years before and after implementing continuous video electroencephalography for 72 hours as a care protocol. Before continuous video electroencephalography, a 60-minute routine electroencephalography was performed at the discretion of the provider...
August 3, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27524453/the-role-of-the-neurointensive-care-nursery-for-neonatal-encephalopathy
#3
REVIEW
Hannah C Glass, David H Rowitch
Neonatal encephalopathy due to intrapartum events is estimated at 1 to 2 per 1000 live births in high-income countries. Outcomes have improved over the past decade due to implementation of therapeutic hypothermia, the only clinically available neuroprotective strategy for hypoxic-ischemic encephalopathy. Neonatal encephalopathy is the most common condition treated within a neonatal neurocritical care unit. Neonates with encephalopathy benefit from a neurocritical care approach due to prevention of secondary brain injury through attention to basic physiology, earlier recognition and treatment of neurologic complications, consistent management using guidelines and protocols, and use of optimized teams at dedicated referral centers...
September 2016: Clinics in Perinatology
https://www.readbyqxmd.com/read/27473650/fellowship-training-in-the-emerging-fields-of-fetal-neonatal-neurology-and-neonatal-neurocritical-care
#4
REVIEW
Christopher D Smyser, Emily W Y Tam, Taeun Chang, Janet S Soul, Steven P Miller, Hannah C Glass
BACKGROUND: Neonatal neurocritical care is a growing and rapidly evolving medical subspecialty, with increasing numbers of dedicated multidisciplinary clinical, educational, and research programs established at academic institutions. The growth of these programs has provided trainees in neurology, neonatology, and pediatrics with increased exposure to the field, sparking interest in dedicated fellowship training in fetal-neonatal neurology. OBJECTIVES: To meet this rising demand, increasing numbers of training programs are being established to provide trainees with the requisite knowledge and skills to independently deliver care for infants with neurological injury or impairment from the fetal care center and neonatal intensive care unit to the outpatient clinic...
October 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27052983/the-neurointensive-care-nursery-and-evolving-roles-for-nursing
#5
Susan Peloquin, Annette Carley, Sonia L Bonifacio, Hannah C Glass
Neonatal neurocritical care is an emerging subspecialty that combines the expertise of critical care medicine and neurology with that of nursing and other providers in an interprofessional team approach to care. Neurocritical care of the neonate has roots in adult and pediatric practice. It has been demonstrated that adults with acute neurologic conditions who are treated in a specialized neurocritical care unit have reduced morbidity and mortality, as well as decreased length of stay, lower costs, and reduced need for neurosurgical procedures...
2016: Neonatal Network: NN
https://www.readbyqxmd.com/read/26562493/feasibility-study-evaluating-therapeutic-hypothermia-for-refractory-status-epilepticus-in-children
#6
MULTICENTER STUDY
Sandra D W Buttram, Alicia K Au, Joshua Koch, Karen Lidsky, Kristin McBain, Nicole O'Brien, Brandon A Zielinski, Michael J Bell
Pediatric refractory status epilepticus (RSE) is a neurological emergency with significant morbidity and mortality, which lacks consensus regarding diagnosis and treatment(s). Therapeutic hypothermia (TH) is an effective treatment for RSE in preclinical models and small series. In addition, TH is a standard care for adults after cardiac arrest and neonates with hypoxic-ischemic encephalopathy. The purpose of this study was to identify the feasibility of a study of pediatric RSE within a research group (Pediatric Neurocritical Care Research Group [PNCRG])...
December 2015: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/26248128/integrating-neurocritical-care-approaches-into-neonatology-should-all-infants-be-treated-equitably
#7
P C Mann, S M Gospe, K J Steinman, B S Wilfond
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...
December 2015: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/26129976/continuous-video-electroencephalographic-eeg-monitoring-for-electrographic-seizure-diagnosis-in-neonates-a-single-center-study
#8
S O Wietstock, S L Bonifacio, J E Sullivan, K B Nash, H C Glass
The objective of this study was to determine the diagnostic yield of continuous video electroencephalographic (EEG) monitoring in critically ill neonates in the setting of a novel, university-based Neonatal Neurocritical Care Service. Patient demographic characteristics, indication for seizure monitoring, and presence of electrographic seizures were obtained by chart review. Among 595 patients cared for by the Neonatal Neurocritical Care Service, 400 (67%) received continuous video EEG. The median duration of continuous video EEG monitoring was 49 (interquartile range = 22-87) hours...
March 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/26093932/grading-hypoxic-ischemic-encephalopathy-severity-in-neonatal-eeg-using-gmm-supervectors-and-the-support-vector-machine
#9
Rehan Ahmed, Andriy Temko, William Marnane, Gordon Lightbody, Geraldine Boylan
OBJECTIVE: This work presents a novel automated system to classify the severity of hypoxic-ischemic encephalopathy (HIE) in neonates using EEG. METHODS: A cross disciplinary method is applied that uses the sequences of short-term features of EEG to grade an hour long recording. Novel post-processing techniques are proposed based on majority voting and probabilistic methods. The proposed system is validated with one-hour-long EEG recordings from 54 full term neonates...
January 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/25988638/outcomes-for-extremely-premature-infants
#10
REVIEW
Hannah C Glass, Andrew T Costarino, Stephen A Stayer, Claire M Brett, Franklyn Cladis, Peter J Davis
Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement...
June 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25727505/interdisciplinary-approach-to-neurocritical-care-in-the-intensive-care-nursery
#11
Hannah C Glass, Elizabeth E Rogers, Susan Peloquin, Sonia L Bonifacio
Neurocritical care is a multidisciplinary subspecialty that combines expertise in critical care medicine, neurology, and neurosurgery, and has led to improved outcomes in adults who have critical illnesses. Advances in resuscitation and critical care have led to high rates of survival among neonates with life-threatening conditions such as perinatal asphyxia, extreme prematurity, and congenital malformations. The sequelae of neurologic conditions arising in the neonatal period include lifelong disabilities such as cerebral palsy and epilepsy, as well as intellectual and behavioral disabilities...
December 2014: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/25380602/neonatal-neurocritical-care-service-is-associated-with-decreased-administration-of-seizure-medication
#12
Sharon O Wietstock, Sonia L Bonifacio, Charles E McCulloch, Michael W Kuzniewicz, Hannah C Glass
This cohort study examines medication use in term neonates with hypoxic-ischemic encephalopathy and seizures before and after implementation of a Neonatal Neurocritical Care Service (N = 108), which included increased seizure monitoring. Nearly all neonates received phenobarbital (96% pre- vs 95% post-Neonatal Neurocritical Care Service) and total loading dose did not vary among groups (33 [95% confidence interval 29-37] vs 30 [26-34] mg/kg). After adjustment for seizure burden, neonates managed during the Neonatal Neurocritical Care Service era, on average, received 30 mg/kg less cumulative phenobarbital (95% confidence interval 15-46 mg/kg) and were on maintenance 5 fewer days (95% confidence interval 3-8 days) than those who were treated prior to implementation of the service...
August 2015: Journal of Child Neurology
https://www.readbyqxmd.com/read/25280143/predictors-of-acute-symptomatic-seizures-after-intracranial-hemorrhage-in-infants
#13
Seema Bansal, Tewodros Kebede, Nathan P Dean, Jessica L Carpenter
OBJECTIVE: To determine the prevalence of acute symptomatic seizures in infants with supratentorial intracranial hemorrhage, to identify potential risk factors, and to determine the effect of acute seizures on long-term morbidity and mortality. DESIGN: Children less than 24 months with intracranial hemorrhage were identified from a neurocritical care database. All patients who received seizure prophylaxis beginning at admission were included in the study. Risk factors studied were gender, etiology, location of hemorrhage, seizure(s) on presentation, and the presence of parenchymal injury...
October 2014: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/25055858/conventional-continuous-eeg-monitoring-in-the-nicu
#14
REVIEW
Taeun Chang, Tammy N Tsuchida
Conventional EEG is being used more frequently in NICUs in the U.S. with the advent of therapeutic hypothermia and the growth of neurocritical care intensivists & units. Historical applications have included assessing encephalopathy, seizure evaluation and prognosis. Past reluctance or limitation of the use in the NICU are receding with the digitization of EEG recordings and increasing interest in the neonatal brain. Continuous EEG monitoring is expanding the potential for its application as a brain monitoring tool to stratify initial injury severity, monitor seizure response to treatment, and detect sentinel neurologic events in the NICU, in addition to guiding neurotherapeutic options...
2014: Current Pediatric Reviews
https://www.readbyqxmd.com/read/24717903/an-electronic-delphi-study-to-establish-pediatric-intensive-care-nursing-research-priorities-in-twenty-european-countries
#15
Lyvonne N Tume, Agnes van den Hoogen, Joke M Wielenga, Jos M Latour
OBJECTIVES: To identify and to establish research priorities for pediatric intensive care nursing science across Europe. DESIGN: A modified three-round electronic Delphi technique was applied. Questionnaires were translated into seven different languages. SETTING: European PICUs. PARTICIPANTS: The participants included pediatric intensive care clinical nurses, managers, educators, and researchers. In round 1, the qualitative responses were analyzed by content analysis and a list of research statements and domains was generated...
June 2014: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/24524454/neonatal-seizures-advances-in-mechanisms-and-management
#16
REVIEW
Hannah C Glass
Seizures occur in approximately 1 to 5 per 1000 live births and are among the most common neurologic conditions managed by a neonatal neurocritical care service. There are several, age-specific factors that are particular to the developing brain, which influence excitability and seizure generation, response to medications, and impact of seizures on brain structure and function. Neonatal seizures are often associated with serious underlying brain injury such as hypoxia-ischemia, stroke, or hemorrhage. Conventional, prolonged, continuous video electroencephalogram is the gold standard for detecting seizures, whereas amplitude-integrated EEG is a convenient and useful bedside tool...
March 2014: Clinics in Perinatology
https://www.readbyqxmd.com/read/23127272/neonatal-neurocritical-care-overlooked-neurologic-syndromes
#17
Hannah C Glass
Although encephalopathy, seizures, and changes in tone comprise the most common signs of neurologic disruption in neonates (and in older children and adults), careful neurologic examination can yield additional clues to assist with the management of underlying neurologic conditions.
December 2012: Pediatric Neurology
https://www.readbyqxmd.com/read/22264706/neonatal-seizures-treatment-practices-among-term-and-preterm-infants
#18
Hannah C Glass, Jessica Kan, Sonia L Bonifacio, Donna M Ferriero
Neonatal seizures are common clinical conditions in both term and preterm neonates, yet no clinical management guidelines for direct care exist. We surveyed 193 international neurologists, neonatologists, and specialists in neonatal neurology or neonatal neurocritical care to assess management practices for seizures in preterm and term neonates. We found high reported rates of electroencephalogram and amplitude-integrated electroencephalogram (aEEG) monitoring to detect neonatal seizures, prevalent use of older anticonvulsant agents, and high rates of neuroimaging...
February 2012: Pediatric Neurology
https://www.readbyqxmd.com/read/22217782/guidelines-for-the-acute-medical-management-of-severe-traumatic-brain-injury-in-infants-children-and-adolescents-second-edition
#19
Patrick M Kochanek, Nancy Carney, P David Adelson, Stephen Ashwal, Michael J Bell, Susan Bratton, Susan Carson, Randall M Chesnut, Jamshid Ghajar, Brahm Goldstein, Gerald A Grant, Niranjan Kissoon, Kimberly Peterson, Nathan R Selden, Robert C Tasker, Karen A Tong, Monica S Vavilala, Mark S Wainwright, Craig R Warden
No abstract text is available yet for this article.
January 2012: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/21874296/neurocritical-care-for-neonates
#20
Hannah C Glass, Sonia L Bonifacio, Thomas Shimotake, Donna M Ferriero
Neurocritical care is an emerging subspecialty that combines expertise in neurology, critical care medicine, neuroradiology, and neurosurgery. Increasing evidence from the adult literature suggests that specialized neurocritical care can lead to improved outcomes following acute brain injury. Critically ill neonates with neurologic conditions may also benefit from specialized neurocritical care. Adherence to guidelines and managing patients in intensive care nurseries with dedicated, multidisciplinary neurocritical care personnel may optimize outcomes...
December 2011: Current Treatment Options in Neurology
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