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      37 segundos (2019). La asfixia neonatal, el minuto de oro en la reanimación y la hipotermia terapéutica desde el prisma del cine Translated title: 37 seconds (2019). perinatal asphyxia, the golden minute of birth and neonatal therapeutic hypothermia from a movie perspective

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          Abstract

          Resumen El artículo utiliza la película 37 segundos para llamar la atención en relación a un grave problema social que es la asfixia perinatal. Se aborda su prevención durante el acompañamiento prenatal, la importancia del minuto de oro en reanimación neonatal, la hipotermia como forma de prevención de secuela neurológica y el monitoreo con electroencefalograma para el diagnóstico de convulsiones.

          Translated abstract

          Summary The article uses the film 37 seconds to draw attention to a serious social problem that is perinatal asphyxia. They talk about prevention during antenatal care, the importance of the golden minute in neonatal resuscitation, hypothermia as a form of prevention of neurological sequelae, and monitoring with an electroencephalogram for the diagnosis of seizures.

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          Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data

          Objective To determine whether moderate hypothermia after hypoxic-ischaemic encephalopathy in neonates improves survival and neurological outcome at 18 months of age. Design A meta-analysis was performed using a fixed effect model. Risk ratios, risk difference, and number needed to treat, plus 95% confidence intervals, were measured. Data sources Studies were identified from the Cochrane central register of controlled trials, the Oxford database of perinatal trials, PubMed, previous reviews, and abstracts. Review methods Reports that compared whole body cooling or selective head cooling with normal care in neonates with hypoxic-ischaemic encephalopathy and that included data on death or disability and on specific neurological outcomes of interest to patients and clinicians were selected. Results We found three trials, encompassing 767 infants, that included information on death and major neurodevelopmental disability after at least 18 months’ follow-up. We also identified seven other trials with mortality information but no appropriate neurodevelopmental data. Therapeutic hypothermia significantly reduced the combined rate of death and severe disability in the three trials with 18 month outcomes (risk ratio 0.81, 95% confidence interval 0.71 to 0.93, P=0.002; risk difference −0.11, 95% CI −0.18 to −0.04), with a number needed to treat of nine (95% CI 5 to 25). Hypothermia increased survival with normal neurological function (risk ratio 1.53, 95% CI 1.22 to 1.93, P<0.001; risk difference 0.12, 95% CI 0.06 to 0.18), with a number needed to treat of eight (95% CI 5 to 17), and in survivors reduced the rates of severe disability (P=0.006), cerebral palsy (P=0.004), and mental and the psychomotor developmental index of less than 70 (P=0.01 and P=0.02, respectively). No significant interaction between severity of encephalopathy and treatment effect was detected. Mortality was significantly reduced when we assessed all 10 trials (1320 infants; relative risk 0.78, 95% CI 0.66 to 0.93, P=0.005; risk difference −0.07, 95% CI −0.12 to −0.02), with a number needed to treat of 14 (95% CI 8 to 47). Conclusions In infants with hypoxic-ischaemic encephalopathy, moderate hypothermia is associated with a consistent reduction in death and neurological impairment at 18 months.
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            Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries: a prospective descriptive observational study.

            Early initiation of basic resuscitation interventions within 60 s in apneic newborn infants is thought to be essential in preventing progression to circulatory collapse based on experimental cardio-respiratory responses to asphyxia. The objectives were to describe normal transitional respiratory adaption at birth and to assess the importance of initiating basic resuscitation within the first minutes after birth as it relates to neonatal outcome. This is an observational study of neonatal respiratory adaptation at birth in a rural hospital in Tanzania. Research assistants (n=14) monitored every newborn infant delivery and the response of birth attendants to a depressed baby. Time to initiation of spontaneous respirations or time to onset of breathing following stimulation/suctioning, or face mask ventilation (FMV) in apneic infants, and duration of FMV were recorded. 5845 infants were born; 5689 were liveborn, among these 4769(84%) initiated spontaneous respirations; 93% in ≤30 s and 99% in ≤60 s. Basic resuscitation (stimulation, suction, and/or FMV) was attempted in 920/5689(16.0%); of these 459(49.9%) received FMV. Outcomes included normal n=5613(96.0%), neonatal deaths n=56(1.0%), admitted neonatal area n=20(0.3%), and stillbirths n=156(2.7%). The risk for death or prolonged admission increases 16% for every 30 s delay in initiating FMV up to six minutes (p=0.045) and 6% for every minute of applied FMV (p=0.001). The majority of lifeless babies were in primary apnea and responded to stimulation/suctioning and/or FMV. Infants who required FMV were more likely to die particularly when ventilation was delayed or prolonged. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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              Occult Neonatal Seizures

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                Author and article information

                Journal
                rmc
                Revista de Medicina y Cine
                Rev Med Cine
                Universidad de Salamanca (Salamanca, Salamanca, Spain )
                1885-5210
                September 2021
                : 17
                : 3
                : 179-186
                Affiliations
                [1] Brasília orgnameHospital Materno Infantil de Brasília Brasil
                Article
                S1885-52102021000300002 S1885-5210(21)01700300002
                10.14201/rmc2021173179186
                c52030c8-a460-4ef0-92eb-61699fa19901

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 26 October 2020
                : 29 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 8
                Product

                SciELO Spain

                Categories
                Originales

                cerebral palsy,neonatal resuscitation,perinatal asphyxia,parálisis cerebral,reanimación neonatal,asfixia perinatal

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