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The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results
BACKGROUND: In 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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502438/ https://www.ncbi.nlm.nih.gov/pubmed/22726296 http://dx.doi.org/10.1186/1471-2431-12-84 |
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author | Pfister, Robert H Bingham, Peter Edwards, Erika M Horbar, Jeffrey D Kenny, Michael J Inder, Terrie Nelson, Karin B Raju, Tonse Soll, Roger F |
author_facet | Pfister, Robert H Bingham, Peter Edwards, Erika M Horbar, Jeffrey D Kenny, Michael J Inder, Terrie Nelson, Karin B Raju, Tonse Soll, Roger F |
author_sort | Pfister, Robert H |
collection | PubMed |
description | BACKGROUND: In 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. METHODS: Eligible 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. RESULTS: From 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. CONCLUSIONS: The 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. |
format | Online Article Text |
id | pubmed-3502438 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35024382012-11-21 The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results Pfister, Robert H Bingham, Peter Edwards, Erika M Horbar, Jeffrey D Kenny, Michael J Inder, Terrie Nelson, Karin B Raju, Tonse Soll, Roger F BMC Pediatr Research Article BACKGROUND: In 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. METHODS: Eligible 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. RESULTS: From 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. CONCLUSIONS: The 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. BioMed Central 2012-06-22 /pmc/articles/PMC3502438/ /pubmed/22726296 http://dx.doi.org/10.1186/1471-2431-12-84 Text en Copyright © 2012 Pfister et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Pfister, Robert H Bingham, Peter Edwards, Erika M Horbar, Jeffrey D Kenny, Michael J Inder, Terrie Nelson, Karin B Raju, Tonse Soll, Roger F The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
title | The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
title_full | The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
title_fullStr | The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
title_full_unstemmed | The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
title_short | The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
title_sort | vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502438/ https://www.ncbi.nlm.nih.gov/pubmed/22726296 http://dx.doi.org/10.1186/1471-2431-12-84 |
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