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Pediatric Grand Rounds (RECORDING) Improving Neurodevelopmental Outcomes in the High-Risk Infant - Science and Art


Pediatric Grand Rounds (RECORDING) Improving Neurodevelopmental Outcomes in the High-Risk Infant - Science and Art Banner

  • Overview
  • Faculty
  • Begin


Date & Location
Wednesday, December 15, 2021, 12:00 AM - Thursday, December 15, 2022, 12:00 AM

Overview
This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice. This recording, presented by Dr. Terrie Inder, will review approaches to improving neurodevelopmental outcomes in prematurely born infants and term born infants with encephalopathy.  

Registration
  Release Date: December 15, 2021
  Expiration Date: December 15, 2022
  Estimated Time to Complete: 1 hour 
  Registration Fee: FREE

*Originally recorded 9/10/2021.

Credits
AMA PRA Category 1 Credits™ (1.00 hours), Non-Physician Participation Credit (1.00 hours)

Target Audience
Specialties - Pediatrics
Professions - Fellow/Resident, Non-Physician, Physician, Student

Objectives
At the conclusion of this activity, participants should be able to:

  1. Evaluate emerging research, updated guidelines, and treatment protocols in order to develop strategies for best practice in the care of pediatric patients.
  2. Describe the neurodevelopmental consequences of being born preterm
  3. Understand the impact of environment and experience on brain development in the NICU
  4. Describe the benefits and risks of therapeutic hypothemia in the term born infant

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 CreditsTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Additional Information

Accessibility Statement
 Stanford University School of Medicine is committed to ensuring that its programs, services, goods and facilities are accessible to individuals with disabilities as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Amendments Act of 2008.  If you have needs that require special accommodations, including dietary concerns, please contact the CME Conference Coordinator.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography
Cheong J LY, Spittle AJ, Burnett AC, Anderson PJ, Doyle LW. Have outcomes following extremely preterm birth improved over time?. Seminars in Fetal & Neonatal medicine. Vol 25, issue 3, 101114. 2020.

Stoll BJ et al. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA. 2015 Sep 8;314(10):1039-51.

Van bel F, Lemmers P, Naulaers G. Monitoring neonatal regional cerebral oxygen saturation in clinical practice: value and pitfalls. Neonatology. 2008;94(4):237-44.
 
Kaiser JR, Gauss CH, Williams DK. The effects of hypercapnia on cerebral autoregulation in ventilated very low birth weight infants. Pediatr Res. 2005 Nov;58(5):931-5.

Noori S, McCoy M, Anderson MP, Ramji F, Seri I. Changes in cardiac function and cerebral blood flow in relation to peri/intraventricular hemorrhage in extremely preterm infants. J Pediatr. 2014 Feb;164(2):264-70.e1-3.

Villamor-Martinez E et al. erebellar Hemorrhage in Preterm Infants: A Meta-Analysis on Risk Factors and Neurodevelopmental Outcome. Front Physiol. 2019 Jun 25;10:800.

Volpe JJ. Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol. 2009 Jan;8(1):110-24.

Lim J, Hagen E. Reducing Germinal Matrix-Intraventricular Hemorrhage: Perinatal and Delivery Room Factors. Neoreviews. 2019 Aug;20(8):e452-e463.

de Bijl K, Brouwer AJ, De Vries LS, Groenendaal F, van Wezel-Meijler G.. Neonatal care bundles are associated with a reduction in the incidence of intraventricular haemorrhage in preterm infants: a multicentre cohort study. Arch Dis Child Fetal Neonatal Ed 2020;105:F419-F424.

Ballabh P, de Vries, LS. White matter injury in infants with intraventricular haemorrhage: mechanisms and therapies. Nature Reviews Neurology volume 17, pages199–214 (2021.

Matthews LG et al. Brain growth in the NICU: critical periods of tissue-specific expansion. Pediatr Res. 2018 May;83(5):976-981.

Deoni S, Dean 3rd D, Joelson S, O’Regan J, Schneider N. Early nutrition influences developmental myelination and cognition in infants and young children. Neuroimage. 2018 Sep;178:649-659.

Ramel SE, Georgieff MK. Preterm nutrition and the brain. World Rev Nutr Diet. 2014;110:190-200.
Embleton ND. Early nutrition and later outcomes in preterm infants. World Rev Nutr Diet. 2013;106:26-32.
 
Horbar JD et al. Weight Growth Velocity and Postnatal Growth Failure in Infants 501 to 1500 Grams: 2000-2013. Pediatrics. 2015 Jul;136(1):e84-92.

Coviello C et al. Effects of early nutrition and growth on brain volumes, white matter microstructure, and neurodevelopmental outcome in preterm newborns. Pediatric Research volume 83, pages102–110 (2018.

Tan M, Abernethy L, Cooke R . Improving head growth in preterm infants—a randomised controlled trial II: MRI and developmental outcomes in the first year. Arch Dis Child Fetal Neonatal Ed 2008; 93: F342–6.

Strommen K, Blakstad EW, Moltu SJ et al, Enhanced nutrient supply to very low birth weight infants is associated with improved white matter maturation and head growth. Neonatology 2015; 107: 68–75.

Beauport L et al, Impact of early nutritional intake on preterm brain: a magnetic resonance imaging study. J Pediatr 2017; 181: 29–36.e1.

Schneider J et al. Nutrient Intake in the First Two Weeks of Life and Brain Growth in Preterm Neonates. Pediatrics. 2018 Mar;141(3):e20172169.

Engelhardt E et al. Regional impairments of cortical folding in premature infants. Ann Neurol. 2015 Jan;77(1):154-62.

Zhang Y et al. Cortical structural abnormalities in very preterm children at 7 years of age. Neuroimage. 2015 Apr 1;109:469-79.

Smith G et al. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. 2011 Oct;70(4):541-9.

Valeri BO, Holsti L, Linhares MBM. Neonatal pain and developmental outcomes in children born preterm: a systematic review. 
Clin J Pain. 2015 Apr;31(4):355-62.

Steinborn R et al. Neonatal morphine exposure in very preterm infants-cerebral development and outcomes. J Pediatr. 2015 May;166(5):1200-1207.e4.

Zwicker JG et al. Smaller Cerebellar Growth and Poorer Neurodevelopmental Outcomes in Very Preterm Infants Exposed to Neonatal Morphine. J Pediatr. 2016 May;172:81-87.e2.

McPherson C et al. Brain Injury and Development in Preterm Infants Exposed to Fentanyl. Ann Pharmacother. 2015 Dec;49(12):1291-7.

Zimmerman KO et al. Sedation, Analgesia, and Paralysis during Mechanical Ventilation of Premature Infants. J Pediatr. 2017 Jan;180:99-104.e1.

Liaw J-J et al. Non-nutritive sucking and facilitated tucking relieve preterm infant pain during heel-stick procedures: a prospective, randomised controlled crossover trial. Int J Nurs Stud. 2012 Mar;49(3):300-9.

Pineda RG et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr. 2014 Jan;164(1):52-60.e2.

Pineda RG et al. Auditory Exposure in the Neonatal Intensive Care Unit: Room Type and Other Predictors. J Pediatr. 2017 Apr;183:56-66.e3.

Jobe AH. A risk of sensory deprivation in the neonatal intensive care unit. J Pediatr. 2014 Jun;164(6):1265-7.

Feldman R, Rosenthal Z, Eidelman AI. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biol Psychiatry. 2014 Jan 1;75(1):56-64.

Vohr B et al. Differential Effects of the Single-Family Room Neonatal Intensive Care Unit on 18- to 24-Month Bayley Scores of Preterm Infants.  J Pediatr. 2017 Jun;185:42-48.e1.
Inder TE. Turns out not where but who you’re with that really matters. Pediatric Research volume 88, pages533–534 (2020)

O’Brien K et al. Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial. Lancet Child Adolesc Health 2018; 2: 245–54

D’Agata AL, Coughlin M, Sanders MR. Clinician Perceptions of the NICU Infant Experience: Is the NICU Hospitalization Traumatic?. Am J Perinatol. 2018 Oct;35(12):1159-1167.


For CME general questions, please contact 
 
   Email: [email protected]



Mitigation of Relevant Financial Relationships


Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.



Member Information
Role in activity
Nature of Relationship(s) / Name of Ineligible Company(s)
Alan R. Schroeder, MD
Clinical Professor
Stanford University
Course Director and Reviewer
Nothing to disclose
Terrie Inder, MB ChB
Chair
Brigham and Womens Hospital
Faculty
Consulting Fee-Aspect Imaging
Debra Babcock, MD
Stanford Childrens (PCHA)
Planner
Nothing to disclose
Caitlin Billingham, MD, MPH
Chief Resident
Stanford Pediatrics
Planner
Nothing to disclose
Faculty Photos
Lisa Jo Chamberlain, MD
Professor of Pediatrics – General Pediatrics
Stanford Children's Health
Planner
Nothing to disclose
Olivera Marsenic Couloures, MD
LPCH
Planner
Nothing to disclose
Lane Donnelly, MD
University of North Carolina
Planner
Nothing to disclose
Faculty Photos
Baraka Dechelle Floyd, MD
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine
Planner
Nothing to disclose
Ingrid Garnica, Other
Stanford Pediatrics
Planner
Nothing to disclose
Charles Gawad, MD, PhD
Associate Professor
Stanford
Planner
Ownership-BioSkryb Genomics
Faculty Photos
Allison Guerin, EdD
Stanford
Planner
Nothing to disclose
Faculty Photos
Mary Beth Leonard, MD, MSCE
Arline and Pete Harman Professor and Chair, Department of Pediatrics
Stanford University
Planner
Nothing to disclose
Stephen J Roth, MPH, MD
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford
Planner
Nothing to disclose
Sarina Tom, BA
Education Operations Manager
Stanford Pediatrics
Planner
Nothing to disclose
Ke-You Zhang, MD
Stanford University
Planner
Nothing to disclose

Improving Neurodevelopmental Outcomes in the High-Risk Infant - Science and Art Module
INSTRUCTIONS:  Click the Launch Video button to watch the video on YouTube. Next, click the Attestation button. Attest to your participation, view results, and complete the evaluation. After successful completion, your credit transcript will be available to view and download immediately in MY CE portal. 

Can’t find the evaluation? Click the MY CE button and select the Evaluation and Certificates tile. Select the Complete Evaluation button associated with the activity. 
 
Launch Video

 

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