July 2014. Volume 10. Number 2

Low Apgar scores at 10 min and long-term outcomes: a new perspective in the neonatal hypothermia time?

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Natarajan G, Shankaran S, Laptook AR, Pappas A, Bann CM, McDonald SA, et al. for the Extended Hypothermia Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Developmetn Neonatal Research Network. Apgar scores at 10 min and outcomes at 6-7 year following hypoxic-ischemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2013;98:F473-F479.
Reviewers: González de Dios J1, Balaguer Santamaría A2.
1Departamento de Pediatría. Hospital General Universitario de Alicante. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 30/04/2014
Acceptance date: 05/05/2014
Publication date: 21/05/2014

Abstract

Authors’ conclusions: among children with perinatal hypoxic-ischemic encephalopathy enrolled, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of all infants with a 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration.

Reviewers’ commentary: classical guidelines recommended 10 minutes as the time to stop resuscitation if heartbeat was not achieved. Based on this study (and others), the International Liaison Committee on Resuscitation and Neonatal Resuscitation currently states that the decision of the time to stop resuscitation may be influenced by the etiology of asphyxia, gestational age, start-up time of resuscitative measures, the current role of therapeutic hypothermia and the opinion of parents.

How to cite this article

González de Dios J, Balaguer A. Apgar bajo a los diez minutos y pronóstico a largo plazo, ¿una nueva perspectiva en tiempos de la hipotermia neonatal? Evid Pediatr. 2014;10:30.

AVC | Critically appraised articles

Natarajan G, Shankaran S, Laptook AR, Pappas A, Bann CM, McDonald SA, et al. for the Extended Hypothermia Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Developmetn Neonatal Research Network. Apgar scores at 10 min and outcomes at 6-7 year following hypoxic-ischemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2013;98:F473-F479.
Reviewers: González de Dios J1, Balaguer Santamaría A2.
1Departamento de Pediatría. Hospital General Universitario de Alicante. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 30/04/2014
Acceptance date: 05/05/2014
Publication date: 21/05/2014

How to cite this article

González de Dios J, Balaguer A. Apgar bajo a los diez minutos y pronóstico a largo plazo, ¿una nueva perspectiva en tiempos de la hipotermia neonatal? Evid Pediatr. 2014;10:30.

References

  1. Casey BM, McIntire DD, Leveno KJ. The continuing value of Apgar score for the assessment of newborn infants. N Engl J Med. 2001;344:667-71.
  2. Laptook AR, Shankaran S, Ambalavanan N, Carlo WA, McDonald SA, Higgins RD, et al; Hypothermia Subcommittee of the NICHD Neonatal Research Network. Outcome of term infants using Apgar scores at 10 minutes following hypoxic-ischemic encephalopathy. Pediatrics. 2009;124:1619-26.
  3. Harrington DJ, Redman CW, Moulden M, Greenwood CE. The long term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort. Am J Obstetr Gynecol. 2007;463:e1-5.
  4. Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, et al. Neonatal Resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary resuscitation and emergency cardiovascular care. Pediatrics. 2010;126:e1400.

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Martín-Ancel A, Alarcón A, García-Alix A. Duración de la reanimación cardiopulmonar cuando no se detecta latido cardiaco al nacimiento. Evid Pediatr. 2014;10:21.