Floris Groenendaal

Publications (499) View all

• Article: Early neurophysiology and MRI in predicting neurological outcome at 9-10years after birth asphyxia.

  T Kontio, M C Toet, L Hellström-Westas, M van Handel, F Groenendaal, S Stjerna, S Vanhatalo, L S de Vries
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  ABSTRACT: OBJECTIVE: To assess whether early somatosensory evoked potentials (SEP) predict long-term neurodevelopmental outcome in normothermic, full-term infants with mild to moderate neonatal encephalopathy (NE), and to compare their predictive value to already available amplitude integrated EEG (aEEG) and magnetic resonance imaging (MRI). METHODS: Fifty-six infants with post-asphyxia NE were prospectively recruited, and their SEP, aEEG and MRI data were acquired during the first five days. Follow-up continued to 9-10years for assessment of neuromotor and neurocognitive development. We analysed SEP latency (N1 component), normality of aEEG background pattern, as well as patterns of injury on the neonatal MRI. Neurological outcome measures at 9-10years included conventional MRI, Movement-ABC and the WISC-III NL. RESULTS: A SEP latency <50ms during the first five days was associated with a normal neuromotor outcome (p<0.03), and a prolonged day 3 latency was associated with lower childhood IQ (p=0.02). The presence of multiple seizures in aEEG, as well as a moderate or severe injury on the neonatal MRI was associated with a poor neuromotor score (p=0.03 and p<0.01, respectively). Combination of multiple techniques improved prediction of long-term outcome compared to single modality. CONCLUSION: Early SEPs provide information that is comparable to the already available aEEG and MRI paradigms in the prediction of long-term outcome of full-term infants with mild to moderate neonatal encephalopathy. SIGNIFICANCE: The present results call for further studies using early SEP to aid early assessment of infants treated with hypothermia.
  Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 02/2013; · 3.12 Impact Factor
• Article: Pharmacokinetics and clinical efficacy of phenobarbital in asphyxiated newborns treated with hypothermia : a thermopharmacological approach.

  M P H van den Broek, F Groenendaal, M C Toet, H L M van Straaten, J G C van Hasselt, A D R Huitema, L S de Vries, A C G Egberts, C M A Rademaker
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  ABSTRACT: Therapeutic hypothermia can influence the pharmacokinetics and pharmacodynamics of drugs, the discipline which is called thermopharmacology. We studied the effect of therapeutic hypothermia on the pharmacokinetics of phenobarbital in asphyxiated neonates, and the clinical efficacy and the effect of phenobarbital on the continuous amplitude-integrated electroencephalography (aEEG) in a prospective study. Data were obtained from the prospective SHIVER study, performed in two of the ten Dutch level III neonatal intensive care units. Phenobarbital data were collected between 2008 and 2010. Newborns were eligible for inclusion if they had a gestational age of at least 36 weeks and presented with perinatal asphyxia and encephalopathy. According to protocol in both hospitals an intravenous (repeated) loading dose of phenobarbital 20 mg/kg divided in 1-2 doses was administered if seizures occurred or were suspected before or during the hypothermic phase. Phenobarbital plasma concentrations were measured in plasma using a fluorescence polarization immunoassay. aEEG was monitored continuously. A one-compartmental population pharmacokinetic/pharmacodynamic model was developed using a multi-level Markov transition model. No (clinically relevant) effect of moderate therapeutic hypothermia on phenobarbital pharmacokinetics could be identified. The observed responsiveness was 66 %. While we still advise an initial loading dose of 20 mg/kg, clinicians should not be reluctant to administer an additional dose of 10-20 mg/kg. An additional dose should be given before switching to a second-line anticonvulsant drug. Based on our pharmacokinetic/pharmacodynamic model, administration of phenobarbital under hypothermia seems to reduce the transition rate from a continuous normal voltage (CNV) to discontinuous normal voltage aEEG background level in hypothermic asphyxiated newborns, which may be attributed to the additional neuroprotection of phenobarbital in infants with a CNV pattern.
  Clinical Pharmacokinetics 10/2012; 51(10):671-9. · 5.40 Impact Factor
• Source

  Available from: J. G. Coen van Hasselt

  Article: Pharmacokinetics and clinical efficacy of phenobarbital in asphyxiated newborns treated with hypothermia: a thermopharmacological approach

  M.P. van den Broek, F. Groenendaal, M.C. Toet, van Straaten H.L, van Hasselt JG, Huitema A.D.R, de Vries L.S, Egberts A.C, Rademaker C.M
  Clinical Pharmacokinetics 08/2012; · 5.40 Impact Factor
• Article: Patterns of placental pathology in preterm infants with a periventricular haemorrhagic infarction: Association with time of onset and clinical presentation.

  J C Harteman, P G J Nikkels, A Kwee, F Groenendaal, L S de Vries
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  ABSTRACT: A periventricular haemorrhagic infarction (PVHI) is a complication of preterm birth with serious consequences. While various risk factors are recognized, little is known about the role of the placenta in the pathogenetic pathway of this type of white matter injury. To evaluate prenatal, maternal and neonatal risk factors and describe placental pathology in infants with typical and atypical timing and presentation of PVHI. : PVHI was defined as typical when the onset was within 6-96 h after birth in the context of established risk factors. PVHI was determined to be atypical when presumed antenatal (<6 h after birth) OR late in the postpartum course (>96 h). Maternal, prenatal and neonatal risk factors were collected retrospectively from patient charts. Microscopic placental pathology was described in 38/45 (84%) preterm infants (GA <34 wks) with a typical PVHI and 14/19 (74%) with an atypical presentation of PVHI. Using univariate analysis clinical factors significantly associated with a typical PVHI were mechanical ventilation (p = 0.00), while fetal heart rate abnormalities (p = 0.00), a planned caesarean section (p = 0.00) and hypertensive disorders (p = 0.01) were associated with an atypical PVHI. Placental pathology was different between the typical vs atypical group with respect to chorioamnionitis (p = 0.04), funisitis (p = 0.05), fetal thrombosis (p = 0.01) and placental infarction (p = 0.00). Chorioamnionitis and funisitis were significantly more common in infants with a typical PVHI. Fetal thrombosis and placental infarction were significantly more often associated with an atypical PVHI. Placental pathology in infants with PVHI reflects underlying disease processes and clinical conditions which may interact with the pathogenic mechanism of PVHI.
  Placenta 07/2012; 33(10):839-44. · 3.69 Impact Factor
• Article: Atypische verwekkers van luchtweginfecties bij pasgeborenen

  N.G. Hartwig, F. Groenendaal
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  ABSTRACT: Al meer dan dertig jaar is bekend dat Chlamydia, Ureaplasma en Mycoplasma geïsoleerd kunnen worden uit materiaal verkregen uit de luchtwegen van pasgeborenen met respiratoire klachten. 1 Echter, in de literatuur is geen consensus of deze micro-organismen werkelijk een belangrijke rol spelen bij ziekteverschijnselen van de pasgeborene.
  Tijdschrift voor kindergeneeskunde 05/2012; 78(1):1-2.