Aisling A. Garvey's research while affiliated with University College Cork and other places

Publications (17)

Article
Introduction: Hypoxic ischaemic encephalopathy (HIE) remains one of the top 10 contributors to the global burden of disease. Early objective biomarkers are required. Near-infrared spectroscopy (NIRS) may provide a valuable insight into cerebral perfusion and metabolism. We aimed to determine whether early NIRS monitoring (<6 h of age) can predict...
Article
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Background: Evidence suggests that earlier diagnosis and initiation of treatment immediately after birth is critical for improved neurodevelopmental outcomes following neonatal encephalopathy (NE). Current diagnostic tests are, however, mainly restricted to clinical diagnosis with no molecular tests available. Purines including adenosine are releas...
Article
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Background: Infants with mild HIE are at risk of significant disability at follow-up. In the pre-therapeutic hypothermia (TH) era, electroencephalography (EEG) within 6 hours of birth was most predictive of outcome. This study aims to identify and describe features of early EEG and heart rate variability (HRV) (<6 hours of age) in infants with mil...
Article
Background: The impact of the permissive hypotension approach in clinically well infants on regional cerebral oxygen saturation (rScO2) and autoregulatory capacity (CAR) remains unknown. Methods: Prospective cohort study of blinded rScO2 measurements within a randomized controlled trial of management of hypotension (HIP trial) in extremely prete...
Article
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Circulatory monitoring is currently limited to heart rate and blood pressure assessment in the majority of neonatal units globally. Non-invasive cardiac output monitoring (NiCO) in term and preterm neonates is increasing, where it has the potential to enhance our understanding and management of overall circulatory status. In this narrative review,...
Article
Background Non-invasive cardiac output monitoring (NICOM) provides continuous estimation of cardiac output. This has potential for use in the delivery suite in the management of acutely depressed term infants. This study aims to measure cardiac output in term infants at delivery and in the first hours of life. Methods Parents of term infants due t...
Article
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Approximately 1 in 10 newborns will require basic resuscitation interventions at birth. Some infants progress to require more advanced measures including the provision of positive pressure ventilation, chest compressions, intubation and administration of volume/cardiac medications. Although advanced resuscitation is infrequent, it is crucial that p...
Conference Paper
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Background Anorexia Nervosa has the highest rate of mortality and morbidity of the mental health conditions. Much of this is related to the physical consequences of starvation and can lead to medical admissions. Integrated care pathways have the potential to decrease admission rates, reduce duration of stay, and prevent patients slipping through ga...
Conference Paper
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Introduction Intraventricular haemorrhage (IVH) occurs in up to 15–20% of babies born before 32 weeks, and up to 30% in babies less than 28 weeks gestation. Injury can cause detrimental short and long-term health outcomes. Heart rate variability (HRV) is a measure of autonomic function controlled by cardiorespiratory reflexes. Depressions and decel...
Conference Paper
Background Cerebral auto-regulation(CAR) in the preterm infant is a complex, multi-factorial process which is still poorly characterised in very preterm infants. It plays a substantial role in the aetiology of intraventricular haemorrhage (IVH). Studies typically examine the relationship between cerebral oxygenation measured using near-infrared spe...
Article
Full-text available
Near-infrared spectroscopy (NIRS) allows for continuous, non-invasive monitoring of end-organ tissue oxygenation. The use of NIRS, cerebral NIRS (cNIRS) in particular, in neonatal care has increased significantly over the last few years. This dynamic monitoring technique provides real-time information on the cerebral and haemodynamic status of the...
Article
Full-text available
For almost half a century, inotropes have been administered to preterm infants with the ultimate goal of increasing their blood pressure. A number of trials, the majority of which focused on dopamine administration, have demonstrated increased blood pressure following inotrope administration in preterm infants and have led to continued use of inotr...
Article
Purpose of review: There has been a significant increase in the utilization of NIRS in neonatal care over the last few years, with some centers now routinely utilizing this monitoring technique for direct intervention at the bedside. In this review, we provide a summary of the most up-to-date evidence on near infrared spectroscopy utilization, wit...

Citations

... Some recent studies using quantitative EEG (qEEG) have reported improved predictive reliability in neonatal HIE [9][10][11]. Quantitative EEG analysis is an excellent tool to evaluate background EEG and utilizes advanced brain-mapping techniques [12]. ...
... 31 The role of dopamine on neonatal cerebral autoregulation is still controversial: while dysfunctional autoregulation had been previously reported in treated preterm infants, [32][33][34] conflicting results have been observed in animal models, 35 and recent data on small neonatal subgroups has not clarified this point further. 36,37 We observed an independent positive association between ongoing dopamine treatment and TOHRx; although this finding requires further validation on larger samples and with higher titrations, it suggests that the vascular effects of dopamine may contribute to alter CBF regulation. Since the indication for dopamine treatment is hypotension itself, establishing the individual role of these two factors on cerebrovascular reactivity remains a challenging issue; in the present study, however, the impact of dopamine was confirmed even after the adjustment for daily-averaged MABP, which, in turn, showed an inverse, independent relationship with TOHRx. ...
... Furthermore, the conventional subjective parameters such as vital signs and physical examination pose several limitations and alone are not reliable in assessing FR, especially in children (28,29). On the other hand, objective parameters such as CO, CI, SV, SI, and SVR may provide much more accurate hemodynamic status (30). More recently, non-invasive cardiac output monitors are also being utilized to provide continuous data of patients' hemodynamic status that could help in guiding fluid therapy and to predict FR (22,31). ...
... Various concerns regarding the accuracy of these non-invasive cardiac output monitors have been raised in adult and pediatric medicine (37,38,46). Despite this, these monitors have been used in neonatology in research and clinical environments for diverse scenarios: monitoring transition at birth (47,48), cardiac adaptation after birth (49), patent ductus arteriosus (PDA)diagnosis (50), PDA ligation (29), PDA medical therapy (51), monitoring congenital heart disease (52,53), managing neonatal hemodynamic shock (54) and sepsis (55), and to predict clinical outcomes (56). ...
... respectively. e current study was consistent with a study conducted by Murphy AA and Halamek LP which recommends that simulation-based education for medical students plays a paramount role for their clinical practice [24]. is might be because both studies used manikins as a simulator (similar level fidelity). ...
... This is particularly relevant in patients under mechanical ventilatory assistance, where hyperventilation can lead to hypocapnia. Low rSaO 2 levels can be good indicators of the need to optimize ventilatory settings (12). Hypercapnia, on the other hand, is associated with cerebral vasodilation and intracranial hemorrhage (13). ...
... Our results demonstrated the highest order of magnitude variation, specifically, a 35-fold difference (1.9-65.8%) in drug use among Chinese NICUs. A lack of reliable normative blood pressure data in preterm infants, non-judicious use of cardiovascular pharmacological support, and diagnostic imprecision related to poor access to TnECHO services may contribute to variations in practice (19)(20)(21)(24)(25)(26). Institutional habits and culture regarding cardiovascular pharmacological support may also play a role in the variation of use rate. ...
... In neonates with single-ventricle CHD, ScO 2 is lower than healthy term infants at baseline [68.0 ± 9.7 (n = 28) compared to 80.6 ± 7.9, n = 16 in healthy controls; p < 0.001] (141), but depending on whether there is right or leftsided obstruction, ScO 2 values can vary (142). Definitive data on whether NIRS monitoring improves patient care is a topic of active investigation (143)(144)(145)(146)(147), although the optimal time to answer this question has likely passed given the near-universal use of NIRS in neonates with operative CHD in the United States. ...
... While some practitioners offer a starting dose in the office, home-based therapies typically involve fewer in-office visits. Studies have shown that even homebased oral immunotherapy for IgE-mediated food allergy can be feasible and safe with very carefully selected patients [9,10], which offers hope for facilitating early commencement of dietary advancement therapy where resources are limited with long waiting times, especially during the COVID-19 pandemic when there were limited non-emergency elective services and lack of regular in-office visits [11,12]. ...