Sarnat stage III – severe HIE — RACP Paediatrics MCQ

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ModerateNeonatalSarnat stage III – severe HIERACP Paediatrics

A term neonate post-asphyxia is comatose with absent reflexes, flaccid tone, no respiratory effort (requiring ventilation), and fixed dilated pupils. What is the Sarnat stage?

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Correct answer: E — Sarnat stage III (severe)

Coma, flaccidity, absent reflexes, no spontaneous respiration, and fixed dilated pupils constitutes Sarnat stage III (severe HIE). Therapeutic hypothermia should still be offered as some evidence supports potential benefit, though prognosis is poor. Prognostication should not be made during the cooling period. EEG monitoring and MRI at 5-7 days provide important prognostic information.

Reference: RCH Melbourne – 2023 – HIE CPG; ANZCOR – 2024