Gabriel Variane, MD, Founder of PBSF – Protecting Brains & Saving Futures
Brazil counts with almost 3 million live births per year, from those, it is estimated 15-20 thousand infants with Hypoxic Ischemic Encephalopathy (HIE), what accounts for approximately 2 infants with HIE per hour.
Like any developing country, the resources available for neonatal care vary widely. Some neonatal tertiary units located in major cities are well structured and equipped, while many NICU’s located in other areas of the country are not. Therefore, the implementation of well stablished neuroprotective strategies such as therapeutic hypothermia (TH) and continuous brain monitoring may not occur or occur in a suboptimal way. This happens due to several factors including lack of expertise, trained personnel, resources, equipment, ongoing support of some subspecialties (e.g. neurology, cardiology) and overall structure needed to care for these critical babies.
Despite previously described benefits, previous studies estimate that less than 5% of Brazilian neonatal centers provide well-structured TH or continuous brain monitoring. We must highlight that there is no robust neonatal transport system in the country to deal specifically with this issue.
Last November we held a conference in Brazil entitled NeoBrain Brazil 2019 – 1st PBSF International Congress on Brain Monitoring and Neuroprotection. The purpose of this congress was to discuss exclusively about the management of infants with birth asphyxia.
This conference was an initiative of PBSF – Protecting Brains & Saving Futures, which is a low cost, self-sustainable project that united a group of specialists that aim to teach, enable and implement protocols of neuroprotection and brain focused care in infants at high risk over the country. Advertising of this event counted with collaboration of a closed social media group called “Neonatologia Brasil,” which was specifically created to disseminate knowledge about neonatal care in Brazil. This group counts with around 17 thousand neonatal health care professionals including neonatologists, neonatal nurses, respiratory therapists, physiotherapists, psychologists and speech therapists.
We were honored to host 9 international speakers (several of them are co-founding members of Newborn Brain Society) and over 900 attendees from every 26 different states of Brazil. This was supposed to be the largest congress created exclusively to discuss about birth asphyxia ever done in Latin America.
Many topics related to HIE were discussed such as the global and national impact; newborn adaptation to extrauterine life and newborn assessment; neurological exam; therapeutic hypothermia; new treatment strategies under study; brain monitoring (aEEG/EEG and NIRS); multidisciplinary attention; hemodynamic management, imaging exams; specific nursing and developmental care; neonatal transport; experience of national and international centers; follow-up and economic burden of HIE. We believe the main idea and accomplishment of NeoBrain Brazil was to raise the awareness of the social-economic impact of birth asphyxia and to discuss brain focused care and clinical management of infants with HIE.
We also had the opportunity to share with all attendees the announcement of foundation of Newborn Brain Society as well as its mission, vision and objectives.
We strongly believe that education and awareness of HIE play an essential role in order to change the reality of treatment of these infants in Brazil. All profit from this conference will be donated to “APAE de Sao Paulo” which is an institute in Brazil that aids children with disabilities.