Positive outcome in a patient with severe hypoxic-ischaemic encephalopathy.

Autor:	Simpson S; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Steinmeyer S; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Nguyen T; Department of Pediatrics, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Nienaber T; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA thomas.nienaber@cchmc.org.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2024 Jun 05; Vol. 17 (6). Date of Electronic Publication: 2024 Jun 05.
DOI:	10.1136/bcr-2024-259877
Abstrakt:	A male infant was born at 40 and 4/7 weeks of gestation via caesarean section for non-reassuring foetal heart tracing. The infant was non-responsive in the delivery room. with no heart rate detected until 40 min of life. The infant's physical examination and laboratory findings were consistent with severe hypoxic-ischaemic encephalopathy. Given the presumption of a very poor neurological prognosis, redirection to comfort care was recommended to the family. However, the family opted for intensive care. The infant underwent therapeutic hypothermia and management of multiorgan dysfunction. The infant survived with no findings of ischaemic injury on MRI and was discharged with no respiratory support and taking all feeds by mouth, with normal development at a year and a half of age. This case report demonstrates the imperative to understand family goals and to acknowledge the need for ongoing humility in providing prognostication for families. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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