Asphyxia ; etiology ; Child ; Dysostoses ; complications ; Female ; Humans ; Osteochondrodysplasias ; Thorax ; abnormalities

Airway Obstruction ; complications ; etiology ; physiopathology ; Asphyxia ; etiology ; physiopathology ; Fibroma ; complications ; pathology ; Humans ; Infant, Newborn ; Oropharyngeal Neoplasms ; complications ; pathology ; Rare Diseases

OBJECTIVETo explore the value of electroencephalogram (EEG) in early diagnosis of brain injury in neonates with asphyxia.

METHODSEEG examination was performed in 49 neonates with asphyxia (mild: n=9; severe: n=40) within 6 hrs of their births. Of the 49 asphyxiated neonates, 33 had concurrent HIE, including 20 cases of mild, 9 cases of moderate and 4 cases of severe HIE.

RESULTSTwenty-one (63.6%) out of the 33 patients with HIE showed abnormal EEG, but only one (6.3%) in the asphyxia group without HIE. All of 13 patients with moderate-severe HIE showed abnormal EEG. The degree of EEG abnormality in neonates with HIE was consistent with the clinical grading of HIE. The neonates whose EEG showed electrical silence and burst suppression and the abnormalities were kept unrecoverable for more than 2 weeks had very poor prognosis.

CONCLUSIONSEEG can reflect brain injury caused by neonatal asphyxia and the severity of brain injury. It may be useful for early diagnosis of brain injury following asphyxia in neonates.

Asphyxia Neonatorum ; complications ; physiopathology ; Early Diagnosis ; Electroencephalography ; Female ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant, Newborn ; Male

Aged ; Asphyxia ; etiology ; mortality ; Female ; Humans ; Vocal Cord Paralysis ; complications ; mortality

Asphyxia ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Retropharyngeal Abscess ; complications ; therapy ; Subphrenic Abscess ; complications ; therapy ; Treatment Outcome

Retrobulbar hemorrhage and permanent visual loss are rare presentations following traumatic asphyxia. In this case, bilateral permanent visual disturbance developed in a woman after chest-crushing trauma without direct trauma to the orbits. A computed tomography scan confirmed bilateral retrobulbar hemorrhages. An ophthalmologic exam revealed bilateral subconjunctival hemorrhages and severe lid edema. Despite high-dose steroid therapy, visual recovery was limited, and optic nerve atrophy developed. Ischemia of the optic nerve associated with retrobulbar hemorrhage may be postulated as one of the causes of permanent visual impairment following traumatic asphyxia.
Asphyxia/*complications/*etiology ; Female ; Humans ; Ischemia/complications ; Middle Aged ; Optic Nerve/blood supply ; Retrobulbar Hemorrhage/*complications/*etiology/radiography ; Thoracic Injuries/*complications ; Tomography, X-Ray Computed ; Vision Disorders/*etiology

OBJECTIVETo investigate the risk factors related to post-asphyxial multiple organ dysfunction (PA-MOD) in neonates.

METHODSA total of 397 neonates with birth asphyxia were enrolled from January 2009 to December 2010.The patients were divided into PA-MOD group (n=179) and non-PA-MOD group (n=218). The risk factors of PA-MOD were retrospectively studied.

RESULTSMultivariate logistic regression analysis showed that severe asphyxia, fetal distress, abnormal labor, and decreased amniotic fluid were the risk factors for PA-MOD among the neonates. Spearman rank correlation analysis showed that the number of the involved organs increased along with the increase of age at admission (P<0.05) and with the decrease of gestational age and birth weight (P<0.05).

CONCLUSIONSThe efforts should be made to enhance perinatal care for neonates, especially for preterm infants and low-birh-weight infants, to decrease the incidence of MOD.

Asphyxia Neonatorum ; complications ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Multiple Organ Failure ; etiology ; prevention & control ; Risk Factors

OBJECTIVETo investigate the high-risk factors for the quality of general movements (GMs), which has a predictive value for brain dysfunction in infants.

METHODSA total of 618 infants in the stage of writhing movements and 539 infants in the stage of fidgety movements were selected separately for the evaluation of GMs. The high-risk factors for the quality of GMs in infants were analyzed by ANOVA, chi-square test, and multivariate logistic regression.

RESULTSMultivariate logistic regression analysis showed that the factors significantly associated with the quality of GMs in the stage of writhing movements were gestational age (OR=0.762, P<0.001), birth weight (OR=0.264, P<0.001), severe asphyxia (OR=2.445, P=0.012), and intrauterine distress (OR=4.865, P<0.001); the factors significantly associated with the quality of GMs in the stage of fidget movements were gestational age (OR=0.786, P=0.003), birth weight (OR=0.217, P<0.001), severe asphyxia (OR=3.765, P=0.001), and hyperbilirubinemia (OR=2.640, P=0.028).

CONCLUSIONSLow gestational age, low birth weight, severe asphyxia, hyperbilirubinemia and intrauterine distress are high-risk factors for abnormal GMs in infants, and early screening and intervention should be performed to reduce the incidence of abnormal nervous system sequelae.

Asphyxia ; complications ; Birth Weight ; Female ; Gestational Age ; Humans ; Infant ; Logistic Models ; Male ; Movement ; Movement Disorders ; etiology ; Risk Factors

PURPOSESuicide becomes a serious problem in today's society and hanging is a common method of suicide. We want to find the factors which can predict the final functional outcomes of these cases.

METHODSAll patients who presented to Accident and Emergency Department (ED) of the National Cheng Kung University Hospital from 1st January 2005 to 31th December 2013 with a hanging injury were included in this study. All cases were divided into good outcome group and bad outcome group according to Glasgow Outcome Scale (GOS). Data was analyzed by Mann-Whitney test and chi-square test.

RESULTSGlasgow Coma Scale (GCS) < 3, pupil dilation and no pupillary light reflex both at the scene and ED were the factors to indicate poor functional outcome. Out-hospital cardiac arrest (OHCA), acidosis (pH < 7.2) and the need for intubation once arriving at ED were also related to poor functional outcome. OHCA cases all had poor functional outcome.

CONCLUSIONGCS, pupil size, pupillary light reflex, OHCA and acidosis are useful as prognostic factors. GCS = 3 lead to a very poor outcome. However, the functional outcome seems good in patients with GCS>3. There parameters can help to predict the outcome before treatment.

Adult ; Aged ; Asphyxia ; complications ; physiopathology ; Emergency Service, Hospital ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Suicide

Asphyxia Neonatorum ; complications ; Humans ; Hypothermia, Induced ; methods ; trends ; Hypoxia-Ischemia, Brain ; diagnosis ; therapy ; Infant, Newborn ; Neurologic Examination