What question did this study set out to answer?

To assess whether universal cord arterial blood gas testing using a pH cutoff of ≤7.10 improves the timely identification of infants with moderate to severe neonatal encephalopathy.

September 23, 2017Archives of Disease in Childhood Fetal & Neonatal

Re-examining the arterial cord blood gas pH screening criteria in neonatal encephalopathy

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Authors

ZVZachary A. VesoulisWashington University in St. Louis SLSteve M. LiaoMount Sinai Hospital RRRakesh RaoSt. Louis Children's Hospital

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Implication

Retrospective cohort study finds a cord blood pH threshold of ≤7.10 improves detection of neonatal encephalopathy, suggesting earlier initiation of therapeutic hypothermia.

Key Points

To assess whether universal cord arterial blood gas testing using a pH cutoff of ≤7.10 improves the timely identification of infants with moderate to severe neonatal encephalopathy.
Retrospective cohort study conducted at a single center among 27,028 births between 2008 and 2015.
Included 412 infants born at ≥36 weeks' gestation without congenital anomalies who had an umbilical cord arterial blood gas (cABG) pH ≤7.10 and underwent mandatory encephalopathy evaluation.
Moderate to severe encephalopathy was diagnosed in 35 of 85 infants with pH <7.00 and 34 of 327 infants with pH between 7.00 and 7.10, with 5 and 13 infants in each group identified solely via pH and clinical examination.
A cABG pH threshold of ≤7.10 yielded a sensitivity of 74.2% and a specificity of 98.7% for detecting moderate to severe encephalopathy.
Screening 25 infants with a cABG pH between 7.00 and 7.10 identified one previously overlooked case of moderate to severe encephalopathy, yielding a 15% increase in cases selected for therapeutic hypothermia.

Cite This Study

Vesoulis et al. (2017) studied this question.

synapsesocial.com/papers/6a6ff3f426a7f98052dc8058 https://doi.org/10.1136/archdischild-2017-313078

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Implication

Retrospective cohort study finds a cord blood pH threshold of ≤7.10 improves detection of neonatal encephalopathy, suggesting earlier initiation of therapeutic hypothermia.

Re-examining the arterial cord blood gas pH screening criteria in neonatal encephalopathy

Discussion

Member takes

Implication

Key Points

Cite This Study

Re-examining the arterial cord blood gas pH screening criteria in neonatal encephalopathy

Discussion

Member takes

Implication

Key Points

Cite This Study

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