Predicting outcome

Cerebral ultrasound and, increasingly, MRI scan findings are the focus of so many difficult conversations between families and the healthcare team regarding prediction of the future. The difference between population estimates of risk and the real life outcomes of individual babies is so hard to encapsulate. Nongena et al provide a very helpful summary of published data linking neuroimaging findings in preterm infants to later outcome, broken down into readily separable categories for each imaging modality. Their concluding sentence is an excellent starting point for anyone. “Wise clinicians have always known that individual tests rarely provide certainty, and they continue to use neuroimaging with circumspection.” See page 388

The 2005 International Liaison Committee on Resuscitation (ILCOR) consensus on science and treatment recommendations for neonatal resuscitation say that “If there are no signs of life after 10 minutes of continuous and adequate resuscitative efforts, it may be justifiable to stop resuscitation.” This was based on a literature that predicted a poor outcome in virtually all cases. …