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Neonatal Intensive Care and Neurophysiological Monitoring

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A special issue of Pediatric Reports (ISSN 2036-7503).

Deadline for manuscript submissions: closed (15 December 2022) | Viewed by 10178

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Special Issue Editors

Dr. Giovanna Bertini

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Guest Editor

Dipartimento Materno- Infantile, Careggi University Hospital, Largo Brambilla n°3, 50134 Florence, Italy
Interests: neonatology; neurology; neurophysiology

Dr. Silvia Lori

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Assistant Guest Editor

Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Largo Brambilla n°3, 50134 Florence, Italy
Interests: neonatology; neurology; neurophysiology

Special Issue Information

Dear Colleagues,

I would like to invite you to participate in this Special Issue “Neonatal Intensive Care and Neurophysiological Monitoring”.

Neurophysiological examinations of infant patients have been more frequently performed over the last several years, thanks to the gradual recognition of the diagnostic support that these investigations can provide along with the prognosis and ongoing assessment of children with relevant diseases. During such a fragile age as the neonatal age, investigations to determine the appropriate development of the central and peripheral nervous systems are of utmost importance. Amplitude-integrated electroencephalography (aEEG) and video electroencephalography (VEEG) make a reliable contribution to assessment of severity, planning of treatment, monitoring, and determination of prognosis of neurological injuries. In recent years, several studies have compared SEPs from neurologically injured infants with presumably normal SEP patterns from control groups. It has also been suggested that a combination of multiple techniques, such as aEEG, VEEG, VEPs, and SEPs, can synergistically improve the prognosis of long-term neurological outcome in comparison with single modalities, and it is hypothesized that multimodal neurophysiological monitoring (MNM) would be useful in evaluating brain activity in neonates as well as in adults.

The purpose of this Special Issue is to highlight the importance of neurophysiological monitoring in defining the outcome of both preterm infants and term infants with hypoxic ischemic encephalopathy or other neurological problems.

There are many studies in the literature that correlate neurophysiological monitoring and brain injury in preterm and term infants, but it would be very useful to highlight which tests are actually useful to perform for prognostic purposes.

In this context, the definition of a correct methodology for carrying out neurophysiological examinations will also be emphasized: in fact, the standardization of the data acquisition method prevents errors in the evaluation of results.

Furthermore, important study projects on artificial intelligence are emerging that will aurtomatically recognize bioelectrical signals for different behavioral states or the onset of seizures.

Thank you for your collaboration.

Dr. Giovanna Bertini
Dr. Silvia Lori
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pediatric Reports is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

preterm infant outcome
hypoxic–ischemic encephalopathy
neurophysiology
neonatal neurology

Published Papers (4 papers)

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Research

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8 pages, 1108 KiB

Open AccessArticle

Association between Thyroid Function and Respiratory Distress Syndrome in Preterm Infants

by Yonghyuk Kim, Youngjin Kim, Meayoung Chang and Byoungkook Lee

Pediatr. Rep. 2022, 14(4), 497-504; https://doi.org/10.3390/pediatric14040058 - 10 Nov 2022

Cited by 1 | Viewed by 2102

Abstract

Thyroid hormones are known to influence the production and secretion of pulmonary surfactant. The objective of this study was to explore the relationship between respiratory distress syndrome (RDS) and thyroid hormones. This was a retrospective study of preterm infants at 24–33 weeks gestational age from April 2017 to February 2019. T₃, free T₄ (fT₄), and thyroid-stimulating hormone (TSH) were measured 1, 3, and 6 weeks after birth. Multivariate logistic regression analyses were performed to determine the relationship between RDS and TSH. A total of 146 infants were enrolled. Of these, 60 had RDS, 72 had no RDS, and 14 were excluded. T₃ and TSH were lower in the RDS groups (p < 0.05) on the day of birth. Multivariate logistic regression analysis indicated that lower serum TSH levels immediately after birth were associated with a higher incidence of RDS (OR, 0.89; 95% CI, 0.81–0.97). The TSH level was associated with the incidence of RDS. This suggests that suppression of the hypothalamus–pituitary axis function contributes to RDS, which is the result of surfactant deficiency. Full article

(This article belongs to the Special Issue Neonatal Intensive Care and Neurophysiological Monitoring)

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8 pages, 1056 KiB

Open AccessArticle

Gestational Age Alters Assessment of Neonatal Abstinence Syndrome

by Sasha Amiri and Jayasree Nair

Pediatr. Rep. 2022, 14(1), 50-57; https://doi.org/10.3390/pediatric14010009 - 28 Jan 2022

Cited by 2 | Viewed by 2813

Abstract

Neonatal abstinence syndrome (NAS) due to maternal opioid use affects both term and preterm infants; however, the relationship between gestational age and clinical symptomatology is still poorly understood. In this study, we compared the clinical features and outcomes of NAS in infants admitted to a neonatal intensive care unit (NICU) based on gestational age groups: preterm (32–36 6/7 weeks) and term (37 weeks or older). A retrospective data analysis was conducted using the medical records of infants with a diagnosis of NAS admitted to a regional perinatal center between 2014 and 2020. A modified Finnegan scoring system was used based on three different symptom categories, including Central Nervous System (CNS), Gastrointestinal (GI) and Other. In total, 166 infants with a diagnosis of NAS were included, with 52 (31%) who were preterm and 114 (69%) who were term. The highest NAS score was significantly lower for the preterm group than for the term group. Preterm infants were less likely to require first-line pharmacotherapy with morphine (52% versus 75%) and to experience GI symptoms during their hospitalization. Newer NAS assessment modalities, such as eat, sleep, console (ESC), may overcome the existing challenges of traditional scoring systems, but will require validation in preterm infants. Full article

(This article belongs to the Special Issue Neonatal Intensive Care and Neurophysiological Monitoring)

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10 pages, 1543 KiB

Open AccessArticle

Comparison of Sympathetic Skin Response (SSR) between Electrical and Acoustic Stimuli in a Healthy Pediatric Population

by Sara Cavaliere, Giovanna Bertini, Cesarina Cossu, Maria Bastianelli, Simonetta Gabbanini, Cristina Mei and Silvia Lori

Pediatr. Rep. 2021, 13(3), 520-529; https://doi.org/10.3390/pediatric13030060 - 1 Sep 2021

Cited by 2 | Viewed by 2639

Abstract

Data in the literature report that latency and morphology in the cutaneous sympathetic skin response (SSR) do not change according to the type of stimulus delivered, unlike the amplitude which shows greater values in relation to the intensity of the physical impact caused in patient. Since the acoustic stimulus represents a method better tolerated by the pediatric patient, the aim of this study is to evaluate the presence or absence of significant differences in SSR between electrical and acoustic stimuli. The SSR was performed for each child of 18 recruited in this study, deriving from the palm of the hand and the sole of the foot and initially delivering an electrical stimulus at the level of the median nerve at the wrist. Two acoustic stimuli were subsequently delivered with the aid of audiometric headphones. Our results show no significant differences for the amplitude values obtained (p values > 0.05). For the latency there was a statistically significant difference (p-value = 0.001) for the left hand, subsequently not confirmed by the comparison performed between the two sides (p-values = 0.28 and 0.56). If these preliminary data are confirmed by a larger sample, the acoustic stimulus could be introduced in a standardized protocol for performing SSR in pediatric patients. Full article

(This article belongs to the Special Issue Neonatal Intensive Care and Neurophysiological Monitoring)

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Other

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8 pages, 1545 KiB

Open AccessCase Report

Unilateral Transient Enhanced SEP during Integrated Multiparameter Neurophysiological Monitoring in a Newborn with Symptomatic Seizure

by Sara Cavaliere, Silvia Lori, Maria Bastianelli, Cesarina Cossu, Simonetta Gabbanini, Carlo Dani and Giovanna Bertini

Pediatr. Rep. 2022, 14(2), 254-261; https://doi.org/10.3390/pediatric14020033 - 27 May 2022

Viewed by 1566

Abstract

During Integrated Multiparametric Neurophysiological Monitoring (IMNA), a newborn with suspected hypoxia at birth and microhaemorrhagic and ischaemic lesions presented some clonic-tonic episodes with specific EEG patterns characterized by rolandic and temporal spikes and the appearance of a unilateral enhanced Somatosensory Evoked Potential (SEP) (10.45 µv). Since the literature does not seem to describe cases of giant SEP in newborns, in this case report, we will discuss the hypotheses underlying this potential. It could be assumed that the ischaemic and haemorrhagic lesions presented by the newborn may have developed as a result of neurotransmitter balance failure. This may be the origin of the EEG picture, which, consequently, could have triggered a potential with high amplitude. Full article

(This article belongs to the Special Issue Neonatal Intensive Care and Neurophysiological Monitoring)

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