Neonatal brain injury has a heterogenous aetiology with a high economic and social burden. Neonatal encephalopathy describes the babies who require resuscitation at birth and have an abnormal neurological examination. It remains difficult to predict their developmental outcomes. Enhanced inflammatory responses are seen in affected infants and correlate with outcomes. Multiorgan dysfunction is common with renal, hepatic, cardiac and haematological abnormalities.

The NIMBUS research team has worked with families of babies who have experienced neonatal encephalopathy (NE) due to intra-partum-related complications (asphyxia, lack of breathing at birth), birth defects (antenatal maternal factors, genetic predisposition, placental abnormalities), infections, thrombophilia, coagulation defects, or metabolic disorders. Thanks to the participation of these families in this research project, we were able to study multi-organ dysfunction and inflammatory mechanism which may persist in later childhood. The NIMBUS research provides us with a better understanding of systemic changes that are caused by NE, and presents us with vital information about perinatal inflammation which has long been associated with brain injury and potential neuropsychiatric conditions later on life.

The NIMBUS programme is funded by the HRB. Its primary research objectives are as follows:

Aim 1: Multiorgan dysfunction in Neonatal Encephalopathy

To standardise clinical multiorgan data collection and investigation in Neonatal encephalopathy in order to improve clinical outcomes and increase parent information. Organ-specific measurement of function will be established using a multidisciplinary expert group.

Aim 2: Inflammatory response in NE

To quantify inflammatory responses as biomarkers and also targets for disease modification.

To understand the detailed inflammatory response in infants with NE in order to develop translational therapies to improve neurological outcome as adjuncts to hypothermia.

Aim 3: Clinical and Biomarker Prognostic Indicators

To evaluate the associations between multiorgan outcome and neurological dysfunction.

To identify important variables that will eventually inform a bedside scoring system to estimate prognosis in the first days of life in an infant with NE. Inflammatory and organ-specific biomarkers may increase the predictive value of the clinical score to create an algorithm of prognostic outcome.

More information about NIMBUS

To learn more about NIMBUS research please read our following publications:

  1. Management of Multi Organ Dysfunction in Neonatal Encephalopathy. O’Dea M, Sweetman D, Bonifacio SL, El-Dib M, Austin T, Molloy EJ. Front Pediatr. 2020 May 15;8:239
  2. Troponin T correlates with MRI results in neonatal encephalopathy. Sweetman DU, Kelly L, Hurley T, Onwuneme C, Watson RWG, Murphy JFA, Slevin M, Donoghue V, Molloy EJ.Acta Paediatr. 2020 Nov;109(11):2266-2270.
  3. Biomarkers of multiorgan injury in neonatal encephalopathy. Aslam S, Molloy EJ.Biomark Med. 2015;9(3):267-75.
  4. Coagulation Profiles Are Associated with Early Clinical Outcomes in Neonatal Encephalopathy.  Sweetman D, Kelly LA, Zareen Z, Nolan B, Murphy J, Boylan G, Donoghue V, Molloy EJ.
  5. Neonatal Encephalopathy: Need for Recognition of Multiple Etiologies for Optimal Management.  Aslam S, Strickland T, Molloy EJ.
  6. Upregulation of Immune Inflammatory gene expression in Neonatal Encephalopathy. M O’Dea, L Kelly, O’Leary JJ, Sweetman D, EJ Molloy.  Pediatric Research published abstract 2017.
  7. Multi-Organ Dysfunction Scoring In Neonatal Encephalopathy: MODE score. Sweetman D, Donoghue V, Boylan GB, Segurado R, Murphy JF, Molloy EJ. Pediatric Research published abstract 2017.
  8. Serial cytokine alterations and abnormal neuroimaging in newborn infants with encephalopathy. O’Hare FM, Watson RW, O’Neill A, Segurado R, Sweetman D, Downey P, Mooney E, Murphy J, Donoghue V, Molloy EJ. Acta Paediatr. 2017 Apr;106(4):561-567.
  9. Perinatal Asphyxia and Erythropoietin and VEGF: Serial Serum and Cerebrospinal Fluid Responses. Sweetman DU, Onwuneme C, Watson WR, Murphy JF, Molloy EJ. Neonatology. 2017;111(3):253-259.
  10. Renal function and novel urinary biomarkers in infants with neonatal encephalopathy. Sweetman DU, Onwuneme C, Watson WR, O’Neill A, Murphy JF, Molloy EJ. Acta Paediatr. 2016 Nov;105(11):e513-e519.

Please click here to see a list of the NIMBUS collaborative partners.


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