Sudden unexpected postnatal collapse

Therapeutic hypothermia for neonates with sudden unexpected postnatal collapse

“…SUPC is a discrete entity defined by the British Association of Perinatal Medicine as ‘a term or near-term infant who is well at birth, assigned to routine postnatal care and who collapses unexpectedly within the first 7 days of life, requiring resuscitation with intermittent positive pressure ventilation, and who either dies, requires ongoing intensive care or develops an encephalopathy’ 7. An underlying condition is identified in approximately one-third of patients and may include congenital cardiac or other defects, infection, metabolic disorders, persistent pulmonary hypertension of the newborn with or without underlying respiratory disease and anaemia 8 9. However, no identifiable cause is found in approximately 50% of patients 8.…”

“…An underlying condition is identified in approximately one-third of patients and may include congenital cardiac or other defects, infection, metabolic disorders, persistent pulmonary hypertension of the newborn with or without underlying respiratory disease and anaemia 8 9. However, no identifiable cause is found in approximately 50% of patients 8. The ‘triple risk hypothesis’, previously used to describe the pathophysiology of sudden infant death syndrome, can similarly be used to describe SUPC 10.…”

“…The ‘triple risk hypothesis’, previously used to describe the pathophysiology of sudden infant death syndrome, can similarly be used to describe SUPC 10. The model includes a period of developmental vulnerability, in this instance the period of postnatal adaptation to extrauterine life, intrinsic vulnerability such as an underlying pathology, and several extrinsic factors including prone position, co-bedding, skin-to-skin contact with possible airway compromise, maternal distraction and altered level of maternal awareness 8 9. Extrinsic risks are the only modifiable factors in SUPC and, although not the focus of this review, should be considered in the development of prevention strategies.…”

“…An established definition has only recently been developed to include specific gestational and postnatal age criteria, clinical presentation and level of support required 7. Severity of cases also plays a role as milder cases may be overlooked and excluded from incidence calculations 8. In addition, much of the data on SUPC is from retrospective case series or reports which are inherently prone to recall bias 8.…”

Sudden Unexpected Postnatal Collapse and Therapeutic Hypothermia: What’s Going On?

“…Because SUPC has been described as more frequent following the widespread use of skin-to-skin practice [ 5 ], guidelines for its prevention have been developed [ 6 , 7 ], and interest has increased regarding the therapeutic options for affected neonates. Particular attention has been paid to therapeutic hypothermia (TH), which is used in hypoxic–ischemic encephalopathy (HIE) [ 8 , 9 ]. Indeed, the brain damage associated with SUPC seems similar to that of HIE, with comparable clinical and neuroradiological findings [ 10 ].…”