Department of Neonatology, King Edward Memorial Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia.
State Child Development Centre, West Perth, Western Australia, Australia.
Arch Dis Child Fetal Neonatal Ed. 2015 Nov;100(6):F492-4. doi: 10.1136/archdischild-2014-307825. Epub 2015 Apr 15.
Infants who have an Apgar score of zero at 10 min of age are known to have poor long-term prognosis. Expert committee guidelines suggest that it is reasonable to cease resuscitation efforts if the asphyxiated infant does not demonstrate a heart beat by 10 min of life. These guidelines are based on data from the era when therapeutic hypothermia was not the standard of care for hypoxic ischaemic encephalopathy (HIE). Hence, we aimed to review our unit data from the era of therapeutic hypothermia to evaluate the outcomes of infants who had an Apgar score of zero at 10 min and had survived to reach the neonatal intensive care unit.
Retrospective chart review.
2007-2013.
13 infants (gestational age ≥35 weeks) with Apgar scores of zero at 10 min were admitted to the neonatal intensive care unit. All were born outside the tertiary perinatal centre. Of them, eight died before discharge. The type and duration of follow-up varied. Of the five survivors, three had normal cognitive scores (100, 100 and 110) on Bayley III assessment at 2 years of age and one had normal Griffiths score (general quotient (GQ) 103) at 1 year. Only one infant developed severe spastic quadriplegia.
4 out of 13 (30.7%) infants with 10 min Apgar scores of zero who survived to reach the neonatal intensive care unit had normal scores on formal developmental assessments. Information from large databases (preferably population based) is necessary to review recommendations regarding stopping delivery room resuscitation in term infants.
出生 10 分钟时 Apgar 评分为 0 的婴儿预后通常较差。专家委员会指南建议，如果窒息婴儿在生命 10 分钟时未出现心跳，则合理停止复苏努力。这些指南是基于治疗性低温尚未成为缺氧缺血性脑病（HIE）标准治疗的时代的数据制定的。因此，我们旨在回顾我们的治疗性低温时代的单位数据，以评估 Apgar 评分为 0 且存活到达新生儿重症监护病房的婴儿的结局。
回顾性图表审查。
2007-2013 年。
13 名（胎龄≥35 周）婴儿在出生 10 分钟时 Apgar 评分为 0 分被收入新生儿重症监护病房。他们均在三级围产中心外出生。其中 8 人在出院前死亡。随访的类型和持续时间各不相同。5 名幸存者中，3 人在 2 岁时进行贝利 III 评估时认知评分正常（100、100 和 110），1 人在 1 岁时进行 Griffiths 评分正常（一般商数（GQ）为 103）。只有 1 名婴儿发展为严重痉挛性四肢瘫痪。
在存活到达新生儿重症监护病房的 10 分钟 Apgar 评分为 0 的 13 名婴儿中，有 4 名（30.7%）在正式发育评估中得分正常。需要来自大型数据库（最好是基于人群的）的信息来审查关于停止足月婴儿产房复苏的建议。
