The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results

BMC Pediatrics

Research Article

Tonse Raju¹  Karin B Nelson²  Peter Bingham³  Michael J Kenny⁴  Robert H Pfister⁴  Erika M Edwards⁴  Jeffrey D Horbar⁵  Roger F Soll⁵  Terrie Inder⁶ 

[1]National Institute of Child Health and Human Development, Bethesda, MD, USA

[2]Vermont Oxford Network Neonatal Encephalopathy Registry Steering Committee Member, Burlington, USA

[3]National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA

[4]Children's Hospital National Medical Center, Washington, DC, USA

[5]Vermont Oxford Network Neonatal Encephalopathy Registry Steering Committee Member, Burlington, USA

[6]University of Vermont, Burlington, VT, USA

[7]Vermont Oxford Network Neonatal Encephalopathy Registry Steering Committee Member, Burlington, USA

[8]University of Vermont, Burlington, VT, USA

[9]Vermont Oxford Network, Burlington, VT, USA

[10]University of Vermont, Burlington, VT, USA

[11]Vermont Oxford Network, Burlington, VT, USA

[12]Vermont Oxford Network Neonatal Encephalopathy Registry Steering Committee Member, Burlington, USA

[13]Washington University, St Louis, MO, USA

[14]Vermont Oxford Network Neonatal Encephalopathy Registry Steering Committee Member, Burlington, USA

关键词: Hypoxic ischemic encephalopathy;    Neonatal encephalopathy;    HIE;    Therapeutic hypothermia;    Asphyxia;    Cooling;    Neuroprotection;    Neonatal encephalopathy;    Registry;   

DOI  :  10.1186/1471-2431-12-84

 received in 2012-02-09, accepted in 2012-06-04,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundIn 2006, the Vermont Oxford Network (VON) established the Neonatal Encephalopathy Registry (NER) to characterize infants born with neonatal encephalopathy, describe evaluations and medical treatments, monitor hypothermic therapy (HT) dissemination, define clinical research questions, and identify opportunities for improved care.MethodsEligible infants were ≥ 36 weeks with seizures, altered consciousness (stupor, coma) during the first 72 hours of life, a 5 minute Apgar score of ≤ 3, or receiving HT. Infants with central nervous system birth defects were excluded.ResultsFrom 2006–2010, 95 centers registered 4232 infants. Of those, 59% suffered a seizure, 50% had a 5 minute Apgar score of ≤ 3, 38% received HT, and 18% had stupor/coma documented on neurologic exam. Some infants experienced more than one eligibility criterion. Only 53% had a cord gas obtained and only 63% had a blood gas obtained within 24 hours of birth, important components for determining HT eligibility. Sixty-four percent received ventilator support, 65% received anticonvulsants, 66% had a head MRI, 23% had a cranial CT, 67% had a full channel encephalogram (EEG) and 33% amplitude integrated EEG. Of all infants, 87% survived.ConclusionsThe VON NER describes the heterogeneous population of infants with NE, the subset that received HT, their patterns of care, and outcomes. The optimal routine care of infants with neonatal encephalopathy is unknown. The registry method is well suited to identify opportunities for improvement in the care of infants affected by NE and study interventions such as HT as they are implemented in clinical practice.

【 授权许可】

CC BY   
© Pfister et al.; licensee BioMed Central Ltd. 2012