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Evidence-Based Neo

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7 Dec, 6 tweets, 6 min read

@CUH_Cork

Next up in "New Approaches to Cooling" Deirdre Murray of @CUH_Cork discussing “Neurodevelopmental Outcomes after Mild HIE.” Read more about Prof. Murray and her work: infantcentre.ie/who-we-are-2/o…

#HotTopicsNeo2020 @HotTopicsNeo

@HotTopicsNeo

Murray begins by defining the population discussed in her lecture: those with encephalopathy 2/2 perinatal asphyxia.

#HotTopicsNeo2020 @HotTopicsNeo

@HotTopicsNeo

How do infants with different HIE severity grades perform on IQ testing at 5 years of age? Summary from:
pubmed.ncbi.nlm.nih.gov/27650049/, which includes additional outcomes measures.

Take home point: mild and moderate HIE infants similar.

#HotTopicsNeo2020 @HotTopicsNeo

@JAMAPediatrics

Murray: prognostic relevance of mild HIE further supported by data in this @JAMAPediatrics pub, showing worse outcomes on BSID-III

pubmed.ncbi.nlm.nih.gov/31710357/

#HotTopicsNeo2020 @HotTopicsNeo

@JPerinatology

Murray: So does cooling improve outcomes in mild HIE? Observational data accumulating, but has limitations. One recent @JPerinatology suggesting possible less white matter injury on MRI.

nature.com/articles/s4137…

#HotTopicsNeo2020 @HotTopicsNeo

@HotTopicsNeo

Murray: RCT data are limited. Point estimates suggest potential benefit, but further trials are needed. Results from recent meta-analysis: pubmed.ncbi.nlm.nih.gov/29496329/

#HotTopicsNeo2020 @HotTopicsNeo

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Evidence-Based Neo

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7 Dec

@MEDNAX

Last in the Rx for BPD trio at #HotTopicsNeo2020: Dr. Reese Clark of @MEDNAX with: "What Drugs are we Using? Practice Variability and Potential Harm." Read more about Dr. Clark's distinguished care:
blog.mednax.com/mednax-neonato…
@HotTopicsNeo

@HotTopicsNeo

Reese: Talk to focus on steroid use. To begin, what postnatal steroids are we using? Dexamethasone and hydrocortisone most common systematic exposures, budenoside most common inhaled exposure.

#HotTopicsNeo2020 @HotTopicsNeo

@MEDNAX

The unstoppable pendulum of postnatal steroid use; data from @MEDNAX clinical data warehouse suggests use again on the rise.

#HotTopicsNeo2020 @HotTopicsNeo

Read 4 tweets

Evidence-Based Neo

@EBNEO

7 Dec

@ChildrensPhila

Next up in #HotTopicsNeo2020: Erik Jensen of @ChildrensPhila discussing how the baseline risk of BPD impacts the number needed to treat when considering effective therapies.

chop.edu/doctors/jensen…

@HotTopicsNeo

@JPediatr

Presentation builds on recently published report in @JPediatr: drugs to Prevent Bronchopulmonary Dysplasia: Effect of Baseline Risk on the Number Needed to Treat
jpeds.com/article/S0022-…

#HotTopicsNeo2020

@HotTopicsNeo

Jensen: objectives of talk:

#HotTopicsNeo2020 @HotTopicsNeo

Read 8 tweets

Evidence-Based Neo

@EBNEO

7 Dec

@HotTopicsNeo

From the last session on periviability at @HotTopicsNeo, let’s get the pulse of the #neoEBM community with a few surveys (thread) #HotTopicsNeo2020

What is the earliest gestational age, assuming dating is correct, where you (or your hospital) routinely offer active postnatal resuscitation if desired by the family

If an infant at 22-24 weeks GA has evidence of inadequate organ perfusion (low urine output, decreasing BP), what is your first line treatment:

Read 6 tweets

Evidence-Based Neo

@EBNEO

7 Dec

@thegerribaer

First up in: "Pharmacotherapy for BPD: We Know Less than We Think We Do" at #HotTopicsNeo2020 is Dr. Gerri Baer (@thegerribaer), Team Leader for Neonatology @US_FDA, discussing "Challenges in Studying Drugs for BPD"
@HotTopicsNeo #neoEBM

@HotTopicsNeo

Baer: no (zero, zilch, none!) drugs approved in the USA to prevent or treat BPD.

Highlights various cohorts demonstrating the ongoing high burden of BPD:

#HotTopicsNeo2020 @HotTopicsNeo

@HotTopicsNeo

Baer: broad view of challenges to BPD Rx, illustrated by 3 buckets: understanding phenotypes/endotypes, definitions and classification and choosing adequate endpoints.
#HotTopicsNeo2020 @HotTopicsNeo

Read 5 tweets

Evidence-Based Neo

@EBNEO

7 Dec

Dr. Mikael Norman discuss care of periviable infants in Sweden #HotTopicsNeo2020

Changes in survival in Sweden, with survival at 22 weeks' gestation around 50% and increasing thereafter

Differences in respiratory support at 22 wk GA

22 wk: 100% mechanically ventilated, mean duration 47 d
26 wk: 1 or 3 mechanically ventilated, mean duration 2 d

Read 6 tweets