Rasmussen Lisa Anne, Bell Emily, Racine Eric
McGill University, Montréal, Québec, Canada Institut de recherches cliniques de Montréal, Montréal, Québec, Canada.
Institut de recherches cliniques de Montréal, Montréal, Québec, Canada.
J Child Neurol. 2016 Oct;31(11):1312-9. doi: 10.1177/0883073816656400. Epub 2016 Jul 4.
Hypoxic ischemic encephalopathy is the most frequent cause of neonatal encephalopathy and yields a great degree of morbidity and mortality. From an ethical and clinical standpoint, neurological prognosis is fundamental in the care of neonates with hypoxic ischemic encephalopathy. This qualitative study explores physician perspectives about neurological prognosis in neonatal hypoxic ischemic encephalopathy. This study aimed, through semistructured interviews with neonatologists and pediatric neurologists, to understand the practice of prognostication. Qualitative thematic content analysis was used for data analysis. The authors report 2 main findings: (1) neurological prognosis remains fundamental to quality-of-life predictions and considerations of best interest, and (2) magnetic resonance imaging is presented to parents with a greater degree of certainty than actually exists. Further research is needed to explore both the parental perspective and, prospectively, the impact of different clinical approaches and styles to prognostication for neonatal hypoxic ischemic encephalopathy.
缺氧缺血性脑病是新生儿脑病最常见的病因，会导致很高的发病率和死亡率。从伦理和临床角度来看，神经学预后在缺氧缺血性脑病新生儿的护理中至关重要。这项定性研究探讨了医生对新生儿缺氧缺血性脑病神经学预后的看法。本研究旨在通过对新生儿科医生和儿科神经科医生进行半结构化访谈，了解预后评估的实践情况。数据分析采用定性主题内容分析法。作者报告了两个主要发现：（1）神经学预后对于生活质量预测和最佳利益考量仍然至关重要；（2）向家长展示磁共振成像结果时所呈现的确定性程度高于实际情况。需要进一步研究以探讨家长的观点，并前瞻性地研究不同临床方法和方式对新生儿缺氧缺血性脑病预后评估的影响。
