EEG for the assessment of neurological function in newborn infants immediately after birth

2018 ◽  
Vol 104 (5) ◽  
pp. F510-F514
Author(s):  
Daragh Finn ◽  
John M O’Toole ◽  
Eugene M Dempsey ◽  
Geraldine B Boylan
Keyword(s):  
Spectral Power ◽  
Elective Caesarean Section ◽  
Newborn Infants ◽  
Maternity Hospital ◽  
Neurological Function ◽  
Transitional Period ◽  
Term Infants ◽  
Movement Artefact ◽  
Central Regions ◽  
Eeg Recordings

ObjectiveTo assess the neurological function of newborn infants in the first minutes after birth using EEG.Design and patientsWe obtained electroencephalography (EEG) recordings in term infants following elective caesarean section. After delivery, disposable EEG electrodes were attached to the infants’ scalp over the frontal and central regions bilaterally and EEG was recorded for 10 min. Both visual and quantitative measures were used to analyse the EEGs.SettingThe operative delivery theatre of Cork University Maternity Hospital, Ireland.ResultsForty-nine infants had EEG recordings over the frontal and central regions. The median (IQR) age at time of initial EEG recording was 3.0 (2.5–3.8) min. While movement artefact contaminated parts of many recordings, good-quality EEG, with mixed-frequency activity with a range of 25–50 μV, was observed in all infants. The majority of EEG spectral power was within the delta band: the median (IQR) relative delta power was 87.8% (83.7%–90%). Almost all (95%) spectral power was below a median (IQR) of 7.56 Hz (6.17–9.76 Hz).ConclusionsEEG recording is very feasible in the immediate newborn period. This study provides valuable objective information about neurological function during this transitional period.

Feasibility of non-invasive cardiac output monitoring at birth using electrical bioreactance in term infants

2020 ◽  
pp. fetalneonatal-2019-318244
Author(s):  
Karen Nora McCarthy ◽  
Andrea Pavel ◽  
Aisling A Garvey ◽  
Ana-Louise Hawke ◽  
Criona Levins ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Elective Caesarean Section ◽  
Maternity Hospital ◽  
Delivery Room ◽  
Cardiac Output Monitoring ◽  
Term Infants ◽  
Non Invasive ◽  
Output Monitoring ◽  
Continuous Estimation ◽  
Median Birth Weight

BackgroundNon-invasive cardiac output monitoring (NICOM) provides continuous estimation of cardiac output. This has potential for use in the delivery suite in the management of acutely depressed term infants. This study aims to measure cardiac output in term infants at delivery and in the first hours of life.MethodsParents of term infants due to be born by elective caesarean section or vaginal delivery at Cork University Maternity Hospital, Ireland were approached in the antenatal period to participate. Cardiac output was measured using a CHEETAH NICOM device, which uses electrical bioreactance technology, at birth and at 2 hours of life.ResultsForty-nine newborns were included. The median gestational age was 39 (IQR: 39–40) weeks and the median birth weight was 3.50 (IQR: 3.14–3.91) kg. Cardiac output measurements were obtained at a median of 8 (IQR: 5–12) min of life. The mean (SD) cardiac output was 101 (24) mL/kg/min in the delivery room and 89 (22) mL/kg/min at 2 hours of life. There was a statistically significant decrease in cardiac output from birth to 2 hours of life (difference in mean (95% CI): 13.5 (9.2 to 17.9) mL/kg/min, p<0.001, n=47). There were no adverse effects associated with NICOM.DiscussionThis technique is feasible and safe in the delivery room. Mean cardiac output measures using NICOM are lower than those found in studies which used echocardiography to determine cardiac output at birth.

Respiratory adaptation in term infants following elective caesarean section

2017 ◽  
Vol 103 (5) ◽  
pp. F417-F421 ◽  
Author(s):  
Daragh Finn ◽  
Julie De Meulemeester ◽  
Lisa Dann ◽  
Ita Herlihy ◽  
Vicki Livingstone ◽  
...  
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Maternity Hospital ◽  
Neonatal Unit ◽  
Term Infants ◽  
Apgar Scores ◽  
Mean Values ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

ObjectiveTo determine respiratory rate (RR), tidal volume (TV) and end-tidal carbon dioxide (EtCO2) values in full-term infants immediately after caesarean section, and to assess whether infants that develop transient tachypnoea of the newborn (TTN) follow the same physiological patterns.Design and patientsA Respironics NM3 Monitor (Philips, Netherlands) continuously measured RR, TV and EtCO2 for 7 min in infants >37 weeks’ gestation following elective caesarean section (ECS). Monitoring was repeated at 2 hours of age for 2 min. Gestation, birth weight, Apgar scores and admissions to neonatal unit were documented.SettingThe operative delivery theatre of Cork University Maternity Hospital, Ireland.ResultsThere were 95 term infants born by ECS included. Median (IQR) gestation was 39 weeks (38.2–39.1) and median (IQR) birth weight 3420 g (3155–3740). Median age at initiation of monitoring was 26.5 s (range: 20–39). Data were analysed for the first 7 min of life. Mean breaths per minute (bpm) increased over the first 7 min of life (44.31–61.62). TV and EtCO2 values were correlated and increased from 1 min until maximum mean values were recorded at 3 min after delivery (5.18 mL/kg–6.44 mL/kg, and 4.32 kPa–5.64 kPa, respectively). Infants admitted to the neonatal unit with TTN had significantly lower RRs from 2 min of age compared with infants not admitted for TTN.ConclusionsTV and EtCO2 values are correlated and increase significantly over the first few minutes following ECS. RR increases gradually from birth, and rates were lower in infants that develop TTN.

The Platelet of the Newborn Infant – Adenine Nucleotide Metabolism and Release

1980 ◽  
Vol 43 (02) ◽  
pp. 099-103 ◽  
Author(s):  
J M Whaun ◽  
P Lievaart ◽  
Keyword(s):  
Newborn Infant ◽  
Adenine Nucleotide ◽  
Platelet Rich Plasma ◽  
Adenine Nucleotides ◽  
Newborn Infants ◽  
Specific Radioactivity ◽  
Nucleotide Metabolism ◽  
Breakdown Product ◽  
Term Infants ◽  
Adenine Nucleotide Metabolism

SummaryBlood from normal full term infants, mothers and normal adults was collected in citrate. Citrated platelet-rich plasma was prelabelled with 3H-adenine and reacted with release inducers, collagen and adrenaline. Adenine nucleotide metabolism, total adenine nucleotide levels and changes in sizes of these pools were determined in platelets from these three groups of subjects.At rest, the platelet of the newborn infant, compared to that of the mother and normal adult, possessed similar amounts of adenosine triphosphate (ATP), 4.6 ± 0.2 (SD), 5.0 ± 1.1, 4.9 ± 0.6 µmoles ATP/1011 platelets respectively, and adenosine diphosphate (ADP), 2.4 ± 0.7, 2.8 ± 0.6, 3.0 ± 0.3 umoles ADP/1011 platelets respectively. However the marked elevation of specific radioactivity of ADP and ATP in these resting platelets indicated the platelet of the neonate has decreased adenine nucleotide stores.In addition to these decreased stores of adenine nucleotides, infant platelets showed significantly impaired release of ADP and ATP on exposure to collagen. The release of ADP in infants, mothers, and other adults was 0.9 ± 0.5 (SD), 1.5 ± 0.5, 1.5 ± 0.1 umoles/1011 platelets respectively; that of ATP was 0.6 ± 0.3, 1.0 ± 0.1,1.3 ± 0.2 µmoles/1011 platelets respectively. With collagen-induced release, platelets of newborn infants compared to those of other subjects showed only slight increased specific radioactivities of adenine nucleotides over basal levels. The content of metabolic hypoxanthine, a breakdown product of adenine nucleotides, increased in both platelets and plasma in all subjects studied.In contrast, with adrenaline as release inducer, the platelets of the newborn infant showed no adenine nucleotide release, no change in total ATP and level of radioactive hypoxanthine, and minimal change in total ADP. The reason for this decreased adrenaline reactivity of infant platelets compared to reactivity of adult platelets is unknown.Infant platelets may have different membranes, with resulting differences in regulation of cellular processes, or alternatively, may be refractory to catecholamines because of elevated levels of circulating catecholamines in the newborn period.

The Added Value of Simultaneous EEG and Amplitude-Integrated EEG Recordings in Three Newborn Infants

Neonatology ◽  
2006 ◽  
Vol 91 (3) ◽  
pp. 212-216 ◽  
Author(s):  
Nathalie K.S. de Vries ◽  
Hendrik J. ter Horst ◽  
Arend F. Bos
Keyword(s):  
Newborn Infants ◽  
Added Value ◽  
Eeg Recordings

scholarly journals Delivery Room Management of Asphyxiated Term and Near-Term Infants

Neonatology ◽  
2021 ◽  
pp. 1-13
Author(s):  
Marlies Bruckner ◽  
Gianluca Lista ◽  
Ola D. Saugstad ◽  
Georg M. Schmölzer
Keyword(s):  
Preterm Infants ◽  
Newborn Infants ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Delivery Room ◽  
Temperature Management ◽  
Term Infants ◽  
Term Newborn ◽  
Resuscitation Guidelines ◽  
Delivery Room Management

Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants.

Neonatal respiratory morbidity following elective caesarean section in term infants

2001 ◽  
Vol 98 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Anemone van den Berg ◽  
Ruurd M van Elburg ◽  
Herman P van Geijn ◽  
Willem P.F Fetter
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Respiratory Morbidity ◽  
Term Infants

Breast-Feeding and Hyperbilirubinemia in Full-Term Newborn Infants

PEDIATRICS ◽  
1985 ◽  
Vol 75 (3) ◽  
pp. 617-618
Author(s):  
CARLO CORCHIA ◽  
MARIA RUIU ◽  
MARCELLO ORZALESI
Keyword(s):  
Breast Feeding ◽  
Newborn Infants ◽  
Positive Association ◽  
Full Term ◽  
Neonatal Hyperbilirubinemia ◽  
Term Infants ◽  
Term Newborn ◽  
School Of Medicine

To the Editor.— Osborn et al1 have reported a positive association between breast-feeding and neonatal hyperbilirubinemia in full-term infants. To give further support to the findings of Osborn et al, we wish to report the results of two similar studies that have been completed in two different hospitals. The first study was carried out in the nursery of the Second School of Medicine of Naples.2 Rooming-in was practiced from 9 am to 12 pm, and during the day, breastfed babies were only offered a supplement of 5% dextrose in water when appropriate.

Renal Injury in Sick Newborn Infants: A Prospective Evaluation Using Urinary β2-Microglobulin Concentrations

PEDIATRICS ◽  
1988 ◽  
Vol 81 (3) ◽  
pp. 432-440
Author(s):  
Eric D. Tack ◽  
Jeffrey M. Perlman ◽  
Alan M. Robson ◽  
Cathy Hausel ◽  
Charles C. T. Chang
Keyword(s):  
Renal Injury ◽  
Confidence Limit ◽  
Newborn Infants ◽  
Tubular Injury ◽  
Creatinine Concentration ◽  
Term Infants ◽  
Urinary Creatinine ◽  
Β2 Microglobulin ◽  
Sick Newborn ◽  
Healthy Infants

Urinary concentrations of β2-microglobulin and creatinine were measured serially in 140 sick infants, of whom 109 were asphyxiated, and in 35 healthy preterm and term infants. First voided urines and samples from days 3 and 7 postpartum were studied. Urinary β2-microglobulin concentrations in healthy infants averaged 1.34 ± 1.34 mg/L (mean ± SD) in first voided specimens and 1.32 ± 0.98 mg/L in day 3 samples; the calculated upper limit of normal (95% confidence limit) was 4.00 mg/L. Elevated values (those exceeding the 95% confidence limit) occurred most often in the sick asphyxiated patients (56%); the first voided sample value in these patients was 10.0 ± 10.4 mg/L. The equivalent value in the sick nonasphyxiated infants was 8.32 ± 7.27 mg/L. Values were significantly and persistently elevated in the sick infants on days 3 and 7. Factoring β2-microglobulin levels by urinary creatinine concentration did not affect the significance of the findings. The increased urinary β2-microglobulin levels were not (1) related to gestational age; low β2-microglobulin values occurred at all gestational ages for both healthy and sick infants; (2) a consequence of urine flow rate; urinary β2-microglobulin did not correlate with urinary creatinine concentration or with urine to plasma creatinine ratio; and (3) a consequence of increased production of β2-microglobulin; urinary and serum β2-microglobulin values did not correlate (r = .03). Thus, we propose that the elevated levels of urinary β2-microglobulin in the sick infants were the consequence of tubular injury. This was associated with hematuria but not with a high incidence of azotemia or oliguria. In the most premature infants (&lt;32 weeks), elevated urinary β2-microglobulin concentrations were associated with significantly increased urinary concentrations of sodium and potassium. These data suggest a higher prevalence of acute tubular injury in sick newborn infants than has been reported in previous studies in which more traditional indices of renal injury were used.

PHYSIOLOGIC HYPERBILIRUBINEMIA AND HEMOLYSIS OF ERYTHROCYTES BY HYDROGEN PEROXIDE SOLUTION IN THE NEWBORN: INVESTIGATION OF A POSSIBLE RELATIONSHIP

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 92-97
Author(s):  
Jo-Anne E. Richards ◽  
Richard B. Goldbloom ◽  
Ronald L. Denton
Keyword(s):  
Hydrogen Peroxide ◽  
Statistical Analysis ◽  
Vitamin E ◽  
Clinical Significance ◽  
Newborn Infant ◽  
Newborn Infants ◽  
Control Group ◽  
Term Infants ◽  
Mean Values ◽  
Relative Deficiency

Forty-three full-term infants have been studied with respect to hemolysis of erythrocytes in solutions of hydrogen peroxide and concentrations of bilirubin in the serum. Mean values for concentration of bilirubin in the serum and percentage of hemolysis followed similar patterns in the first few days of life. However, statistical analysis of the data in individual cases showed no significant correlation between the degree of hemolysis in solutions of hydrogen peroxide and the concentrations of bilirubin in the serum. Administration of vitamin E prevented an increase in hemolysis of erythrocytes in solutions of hydrogen peroxide but failed to produce any significant change in concentrations of bilirubin as compared with the control group. The evidence suggests that the relative deficiency of vitamin E which exists in most newborn infants does not play a part in the causation or maintenance of physiologic hyperbilirubinemia. The clinical significance of increased hemolysis of the erythrocytes of the newborn infant in solutions of hydrogen peroxide remains a mystery. Possible approaches to the clarification of this problem are suggested.

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