HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Improving infant outcome with a 10 min Apgar of 0.

AbstractOBJECTIVE:
Asystole at birth and extending through 10 min is rare, with current international recommendations stating it may be appropriate to consider discontinuation of resuscitation in this clinical scenario. These recommendations are based on small case series of both term and preterm infants, where death or abnormal outcome was nearly universal. Study objective was to determine recent outcome of infants with an Apgar score of 0 at 10 min despite cardiopulmonary resuscitation, treated with therapeutic hypothermia or standard treatment, in randomised cooling studies.
DESIGN:
Outcome studies of infants with an Apgar of 0 at 10 min subsequently resuscitated and treated with hypothermia or standard treatment were reviewed and combined with local outcome data of infants treated with hypothermia.
RESULTS:
Four recent studies (n=81) and local data (n=9) yielded a total of 90 infants with an Apgar of 0 at 10 min, with 56 treated with hypothermia and 34 controls. Primary outcome of death or abnormal neurodevelopmental outcome (18-24 months) occurred in 73% cooled and 79.5% normothermic infants (p=0.61).
IMPLICATIONS:
Although poor, the outcome for infants with an Apgar of 0 at 10 min of life has improved substantially in recent years. This may be related to treatment with hypothermia, enhanced resuscitation techniques and/or other supportive management. Current recommendations to consider discontinuation of resuscitation without a detectable heart rate at 10 min should consider these findings.
AuthorsEricalyn Kasdorf, Abbot Laptook, Dennis Azzopardi, Susan Jacobs, Jeffrey M Perlman
JournalArchives of disease in childhood. Fetal and neonatal edition (Arch Dis Child Fetal Neonatal Ed) Vol. 100 Issue 2 Pg. F102-5 (Mar 2015) ISSN: 1468-2052 [Electronic] England
PMID25342246 (Publication Type: Journal Article, Review)
CopyrightPublished by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Topics
  • Apgar Score
  • Cardiopulmonary Resuscitation
  • Heart Arrest (therapy)
  • Humans
  • Hypothermia, Induced
  • Infant, Newborn
  • Perinatal Care (methods)
  • Prognosis
  • Randomized Controlled Trials as Topic (methods)
  • Time Factors
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: