Sarnat staging, Sarnat Classification or the Sarnat Grading Scale is a classification scale for hypoxic-ischaemic encephalopathy of the newborn (HIE), a syndrome caused by a lack of adequate oxygenation around the time of birth which manifests as altered consciousness, altered muscle tone, and seizures.Sarnat H, Sarnat M. Neonatal encaphalopathy following fetal distress. Arch Neurol. 33:695 - 705. 1976. HIE is graded based on the infant's clinical presentation, examination findings, the presence of seizures and the duration of illness. Sarnat staging is used alongside electroencephalogram (EEG) findings to provide information about the prognosis for the infant. Mild HIE, according to the scale, usually has a normal outcome, whereas in severe HIE the mortality rate is 75%, and 80% of survivors have neurological sequelae.Gardiner M, Eisen S, Murphy C. Training in paediatrics: the essential curriculum. Oxford University Press, Oxford 2009.
UK Resuscitation Council guidelines on newborn life support recommend that a baby who received significant resuscitation at birth and who goes on to show signs of encephalopathy should be assessed by Sarnat Staging between 24 and 48 hours from birth.Newborn Life Support: Third Edition. Resuscitation Council (UK), London 2011.
Staging Grade I Mild Grade II Moderate Grade III Severe Alertness Hyperalert Lethargy Coma Muscle tone Normal or increased Hypotonic Flaccid Seizures None Frequent Uncommon Pupils Dilated, reactive Small, reactive Variable, fixed Respiration Regular Periodic Apnoea Duration < 24 Hours 2 - 14 Days Weeks Adapted from
See also Cerebral hypoxia
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