Follow-up in Neonatal Extracorporeal Membrane Oxygenation (ECMO)

1995 ◽  
Vol 18 (10) ◽  
pp. 584-588 ◽  
Author(s):  
W.B. Geven ◽  
L.A.J. Nabuurs-Korhman ◽  
J.M. van Kessel-Feddema ◽  
C. Festen
Keyword(s):  
Ct Scan ◽  
Neurological Status ◽  
Mental Development ◽  
Psychomotor Development ◽  
Development Index ◽  
Mental Development Index ◽  
Respiratory Status ◽  
Developmental Index ◽  
One Year

In 34 survivors of the first 43 ECMO patients from our institution before discharge to another hospital or home an EEG, BAER, Head Ultrasonography, cerebral CT scan, Dubowitz score and ophthalmological inspection were performed. At one year of age Mental Developmental Index of the Bayley scales, Motor Quotient as well as pulmonary and neurological status were assessed. In 29 patients follow-up took place in our hospital. In 17 of them (59%) all tests before discharge were normal, 2 patients (7%) showed an abnormal BAER, an additional 5 patients (17%) had abnormal EEG and 2 patients (7%) had abnormal HUS in combination with abnormal cerebral CT scan. In 19 patients (33%) the Dubowitz score was abnormal at discharge. At one year of age neurological status was normal in 25 (86%) patients, respiratory status was normal in 22 (76%) and Mental Development Index was > 80 in 23 of the patients (79%). A significant correlation between Mental Development Index and Motor Quotient was found r=0.50, p=0.0065. It is concluded that more than one abnormal neurophysiological test before discharge may identify patients with additional risks for adverse outcome and that the respiratory status influenced psychomotor development at one year of age.

Micropremies

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 167-167
Author(s):  
HARLEY G. GINSBERG
Keyword(s):  
Birth Weight ◽  
Neurodevelopmental Outcome ◽  
Mental Development ◽  
Female Infant ◽  
Developmental Assessment ◽  
Development Index ◽  
Mental Development Index ◽  
Developmental Index

To the Editor.— We read with great interest the editorial submitted by Drs Moro and Minoli describing the neurodevelopmental outcome of an infant who was delivered at 27 weeks gestation with a birth weight of 450 g.1 We were disappointed, however, that they overlooked our recent report of a 380-g female infant who was delivered at 25 3/7 weeks gestation.2 Our infant, Monica, is developing normally after a 122-day hospitalization. Her 20-month Bayley developmental assessment revealed a mental development index of 69 (102 when corrected for prematurity), and psychomotor developmental index of 97 (122 when corrected for prematurity).

scholarly journals The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants

2019 ◽  
Vol 57 (1) ◽  
pp. 63-71
Author(s):  
Andrew B Goldstone ◽  
Michael Baiocchi ◽  
David Wypij ◽  
Christian Stopp ◽  
Dean B Andropoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mental Development ◽  
Psychomotor Development ◽  
Absolute Difference ◽  
Systematic Bias ◽  
Development Index ◽  
Mental Development Index ◽  
Neurodevelopmental Disability ◽  
Psychomotor Development Index ◽  
Bayley Scales

Abstract OBJECTIVES Neurodevelopmental disability is the most common complication among congenital heart surgery survivors. The Bayley scales are standardized instruments to assess neurodevelopment. The most recent edition (Bayley Scales of Infant and Toddler Development 3rd Edition, Bayley-III) yields better-than-expected scores in typically developing and high-risk infants than the second edition (Bayley Scales of Infant Development 2nd Edition, BSID-II). We compared BSID-II and Bayley-III scores in infants undergoing cardiac surgery. METHODS We evaluated 2198 infants who underwent operations with cardiopulmonary bypass between 1996 and 2009 at 26 institutions. We used propensity score matching to limit confounding by indication in a subset of patients (n = 705). RESULTS Overall, unadjusted Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores (90.7 ± 17.2 vs 77.6 ± 18.8, P < 0.001), and unadjusted Bayley-III composite cognitive and language scores were higher than BSID-II Mental Development Index scores (92.0 ± 15.4 vs 88.2 ± 16.7, P < 0.001). In the propensity-matched analysis, Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores [absolute difference 14.1, 95% confidence interval (CI) 11.7–17.6; P < 0.001] and the Bayley-III classified fewer children as having severe [odds ratio (OR) 0.24; 95% CI 0.14–0.42] or mild-to-moderate impairment (OR 0.21; 95% CI 0.14–0.32). The composite of Bayley-III cognitive and language scores was higher than BSID-II Mental Development Index scores (absolute difference 4.0, 95% CI 1.4–6.7; P = 0.003), but there was no difference between Bayley editions in the proportion of children classified as having severe cognitive and language impairment. CONCLUSIONS The Bayley-III yielded higher scores than the BSID-II and classified fewer children as severely impaired. The systematic bias towards higher scores with the Bayley-III precludes valid comparisons between early and contemporary cardiac surgery cohorts.

Successful Renal Transplantation Accelerates Development in Young Uremic Children

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 594-600
Author(s):  
Ira D. Davis ◽  
Pi-Nian Chang ◽  
Thomas E. Nevins
Keyword(s):  
Renal Failure ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Standard Deviation Score ◽  
Mental Development ◽  
Psychomotor Development ◽  
Paired Data ◽  
Development Index ◽  
Mental Development Index ◽  
The Impact

To examine the impact of renal transplantation on subsequent development of children with chronic renal failure, 37 children undergoing primary renal transplantation at or before 30 months of age whose allograft functioned for at least 1 year were prospectively studied. Psychometric tests were performed an average of 4 months before transplantation; reevaluation was done an average of 14 months after surgery. Comparison of individual pretransplantation and posttransplantation mental development scores in 33 patients, assessed by either Bayley Mental Development Index or Stanford-Binet Intelligence Quotient, revealed an average increase of 12.6 (P < .001). After transplantation, there was a significant improvement in mental performance in 12 of 18 patients (P < .02) from the range of mild delay (Mental Development Index or Stanford-Binet IQ score = 50 to 69) to the range of normal mental development (70). The Bayley Psychomotor Development Index scores were frequently lower than Mental Development Index scores and also increased an average of 14.4 (P < .01) after transplantation in all 12 patients with paired data. Significant individual improvement in occipital-frontal circumference standard deviation score (P < .001) was noted in 24 children after transplantation. It is concluded that successful renal transplantation in young children with chronic renal failure is often associated with significant improvements in cognitive and psychomotor function, as well as improved cephalic growth.

scholarly journals Role of methyleprednisolone succinate in the management of acute spinal cord injury

1970 ◽  
Vol 9 (3) ◽  
pp. 168-172
Author(s):  
NK Karn ◽  
BP Shrestha ◽  
GP Khanal ◽  
R Rijal ◽  
P Chaudhary ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Status ◽  
Acute Spinal Cord Injury ◽  
Cord Injury ◽  
And Gender ◽  
One Year

Objective: To see the role of methyleprednisolone succinate in the management of acute spinal cord injury. Methods: A randomized control trial was done including the patients with acute spinal cord injury. They were divided into age and gender matched two groups. Patients with presence of active infection, associated open fracture, those on long term steroid and those who did not give consent to participate in the trial were excluded. One group received methyleprednisolone succinate within 8 hours of injury and another group did not receive the drug. Both the groups were managed nonoperatively. The neurological status of the patients was assessed at presentation, once spinal shock was over, at 6th week and 6th month and after one year according to ASIA scoring. Frankel grading was also assessed in every follow up. Conclusion: Methylprednisolone succinct prevents secondary cord injury to a great extent and hence its administration within 8 hours of injury results in a better functional (motor and sensory) outcome. Keywords: acute spinal cord injury; methyleprednisolone succinate DOI: http://dx.doi.org/10.3126/hren.v9i3.5585   HR 2011; 9(3): 168-172

scholarly journals Effect of kangaroo mother care on neurodevelopmental outcome of low birth weight babies: a one-year randomized control trial

2018 ◽  
Vol 5 (2) ◽  
pp. 508 ◽  
Author(s):  
Prathiba N. Doddabasappa ◽  
N. S. Mahantshetti ◽  
Mahesh Kamate ◽  
Adarsh E.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Muscle Tone ◽  
Neurodevelopmental Outcome ◽  
Kangaroo Mother Care ◽  
Psychomotor Development ◽  
Care Group ◽  
Development Index ◽  
Low Birth Weight Babies ◽  
One Year

Background: Low birth weight (LBW) is one of the risk factor for neurodevelopmental delay. The present study was undertaken to assess the role of the Kangaroo Mother Care (KMC) in the neurodevelopmental outcome of low birth weight babies. Methods: The present study was undertaken at Department of Paediatrics, Jawarharlal Medical college, Belgaum during the period from January 2009 to October 2010. The study includes 80 stable LBW babies were randomized into 40 in the KMC group and 40 in convention method of care group. 36 babies in the KMC group and 33 babies in the CMC group completed the study. The Neurodevelopmental outcome was assessed by the Amiel Tison test at three, six, nine and twelfth months of age. This was compared with BSID test, at one year.Results: The neurosensory examination and passive muscle tone (PMT) were found to be abnormal. Majority of the babies in both groups has a normal neurosensory and PMT development at one year. Statistically significant to muscle tone deficit was observed in the CMC babies at six months and nine months (p = 0.005 and p = 0.013). With respect to BSID, 16 and 29 KMC babies had a normal Psychomotor Development Index (PDI) and Motor Development Index (MDI) scores when compared to 8 and 18 CMC babies (p = 0.003 and p = 0.057 respectively). Number of babies with significant delay was observed to be higher in the CMC group being 11 versus 1 for PDI scores and 4 versus 1 for MDI scores.Conclusions: The present study shows that KMC has a beneficial effect on the neurodevelopmental outcome of low birth weight babies and BSID II is a better test to detect the psychomotor and mental developmental delay when compared to the Amiel Tison test.

Effect of Iron Therapy on Behavior Performance in Nonanemic, Iron-Deficient Infants

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 877-880 ◽  
Author(s):  
Frank A. Oski ◽  
Alice S. Honig ◽  
Brenda Helu ◽  
Peter Howanitz
Keyword(s):  
Iron Deficiency ◽  
Mental Development ◽  
Mean Cell Volume ◽  
Ferritin Concentration ◽  
Development Index ◽  
Biochemical Alterations ◽  
Mental Development Index ◽  
Iron Deficient ◽  
Serum Ferritin Concentration ◽  
Parenteral Iron

In an effort to determine whether iron deficiency, in the absence of anemia (hemoglobin >11.0 g/dL), might produce alterations in behavioral development, four groups of nonanemic infants, 9 to 12 months of age, with varying degrees of iron deficiency were studied. Infants were classified as iron sufficient, iron depleted, or iron deficient based on measurements of serum ferritin concentration, erythrocyte protoporphyrin values, and the mean cell volume of erythrocytes. Subjects in each group were tested with the Bayley Mental Development Index, treated with parenteral iron, and retested seven days later. The administration of iron produced a significant increase in the Mental Development Index scores (+21.6 points) in the infants with iron deficiency but no significant change in the scores of infants with iron sufficiency (+6.2 points) or only iron depletion (+5.6 points). It is concluded that iron deficiency, even in the absence of anemia, results in biochemical alterations that impair behavior in infants.

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