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Therapeutic hypothermia in newborn

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https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#1
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28393884/novel-wavelet-real-time-analysis-of-neurovascular-coupling-in-neonatal-encephalopathy
#2
Lina F Chalak, Fenghua Tian, Beverley Adams-Huet, Diana Vasil, Abbot Laptook, Takashi Tarumi, Rong Zhang
Birth asphyxia constitutes a major global public health burden for millions of infants, despite hypothermia therapy. There is a critical need for real time surrogate markers of therapeutic success, to aid in patient selection and/or modification of interventions in neonatal encephalopathy (NE). This is a proof of concept study aiming to quantify neurovascular coupling (NVC) using wavelet analysis of the dynamic coherence between amplitude-integrated electroencephalography (aEEG) and near-infrared spectroscopy in NE...
April 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28376079/pattern-of-brain-injury-and-depressed-heart-rate-variability-in-newborns-with-hypoxic-ischemic-encephalopathy
#3
Marina Metzler, Rathinaswamy Govindan, Tareq Al-Shargabi, Gilbert Vezina, Nickie Andescavage, Yunfei Wang, Adre du Plessis, An N Massaro
BACKGROUND: Decreased heart rate variability (HRV) is a measure of autonomic dysfunction and brain injury in newborns with hypoxic ischemic encephalopathy (HIE). This study aimed to characterize the relationship between HRV and brain injury pattern by MRI in newborns with HIE undergoing therapeutic hypothermia. METHODS: HRV metrics were quantified in the time domain (αS, αL, and root mean square at short [RMSS] and long [RMSL] time scales) and frequency domain (relative low-[LF] and high-frequency [HF] power) during the time period 24-27 h of life...
April 4, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28355608/new-wavelet-neurovascular-bundle-for-bedside-evaluation-of-cerebral-autoregulation-and-neurovascular-coupling-in-newborns-with-hypoxic-ischemic-encephalopathy
#4
Lina F Chalak, Rong Zhang
Neonatal encephalopathy (NE) resulting from birth asphyxia constitutes a major global public health burden for millions of infants every year, and despite therapeutic hypothermia, half of these neonates have poor neurological outcomes. As new neuroprotective interventions are being studied in clinical trials, there is a critical need to establish physiological surrogate markers of therapeutic efficacy, to guide patient selection and/or to modify the therapeutic intervention. The challenge in the field of neonatal brain injury has been the difficulty of clinically discerning NE severity within the short therapeutic window after birth or of analyzing the dynamic aspects of the cerebral circulation in sick NE newborns...
March 30, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28351039/prognostic-value-of-the-apparent-diffusion-coefficient-in-newborns-with-hypoxic-ischaemic-encephalopathy-treated-with-therapeutic-hypothermia
#5
Eva-Marie Heursen, Amaya Zuazo Ojeda, Isabel Benavente Fernández, Gema Jimenez Gómez, Rosalía Campuzano Fernández-Colima, José Paz-Expósito, Simón Pedro Lubián López
BACKGROUND: Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia. OBJECTIVES: To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH). METHODS: This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH...
March 29, 2017: Neonatology
https://www.readbyqxmd.com/read/28288145/rectal-temperature-in-the-first-five-hours-after-hypoxia-ischaemia-critically-affects-neuropathological-outcomes-in-neonatal-rats
#6
Thomas Wood, Catherine Hobbs, Mari Falck, Anne Charlotte Brun, Else Marit Løberg, Marianne Thoresen
BACKGROUND: Hyperthermia after hypoxia-ischaemia (HI) in newborn infants is associated with worse neurological outcomes. Loss of thermoregulation may also be associated with greater injury. METHODS: In the postnatal-day 7 (P7) rat, the effect of 5h of graded hyperthermia (38°C or 39°C) immediately after unilateral HI was compared to normothermia (NT, 37°C), and therapeutic hypothermia (TH, 32°C). Early (negative geotaxis) and late (staircase test) behavioural testing was performed, as well as neuropathology scoring in adulthood...
March 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28253907/systemic-pro-inflammatory-cytokine-status-following-therapeutic-hypothermia-in-a-piglet-hypoxia-ischemia-model
#7
Eridan Rocha-Ferreira, Dorottya Kelen, Stuart Faulkner, Kevin D Broad, Manigandan Chandrasekaran, Áron Kerenyi, Takenori Kato, Alan Bainbridge, Xavier Golay, Mark Sullivan, Boris W Kramer, Nicola J Robertson
BACKGROUND: Inflammatory cytokines are implicated in the pathogenesis of perinatal hypoxia-ischemia (HI). The influence of hypothermia (HT) on cytokines after HI is unclear. Our aim was to assess in a piglet asphyxia model, under normothermic (NT) and HT conditions: (i) the evolution of serum cytokines over 48 h and (ii) cerebrospinal fluid (CSF) cytokine levels at 48 h; (iii) serum pro/anti-inflammatory cytokine profile over 48 h and (iv) relation between brain injury measured by magnetic resonance spectroscopy (MRS) and brain TUNEL positive cells with serum cytokines, serum pro/anti-inflammatory cytokines and CSF cytokines...
March 3, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28252661/predictive-value-of-amplitude-integrated-eeg-aeeg-after-rescue-hypothermic-neuroprotection-for-hypoxic-ischemic-encephalopathy-a-meta-analysis
#8
M Chandrasekaran, B Chaban, P Montaldo, S Thayyil
OBJECTIVE: Amplitude-integrated electroencephalography (aEEG) is a useful bedside tool in predicting the neurodevelopmental outcome after neonatal encephalopathy; however, the prognostic accuracy may be altered by rescue hypothermic neuroprotection. The objective of this study is to examine the prognostic accuracy of aEEG for predicting long-term neurodevelopmental outcomes in term newborn infants undergoing therapeutic hypothermia for neonatal encephalopathy. STUDY DESIGN: We examined all studies (Medline, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library; 2000 to 2014) comparing aEEG (6, 24, 48 or 72 h) in term encephalopathic babies undergoing therapeutic hypothermia, with neurodevelopmental outcome at 1 year or more...
March 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28217152/value-of-electroencephalographic-monitoring-in-newborns-with-hypoxic-ischemic-encephalopathy-treated-with-hypothermia
#9
Hatem Hamed Elshorbagy, Ahmed A Azab, Naglaa M Kamal, Naglaa Fathy Barseem, Mohamed M Bassiouny, Mostafa A Elsayed, Tohamy H Elkhouly
BACKGROUND: The values of electroencephalography (EEG) in neonatal hypoxic-ischemic encephalopathy (HIE) during therapeutic hypothermia (TH) are still uncertain. AIMS: The aim of this study is to detect EEG background, the prevalence of seizures during cooling, and to determine different EEG patterns that can predict brain injury in magnetic resonance imaging (MRI). PATIENTS AND METHODS: Thirty-nine newborns with HIE were subjected to TH. Continuous monitoring by video-EEG was carried out throughout cooling and during rewarming...
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28112011/optimal-duration-of-continuous-video-electroencephalography-in-term-infants-with-hypoxic-ischemic-encephalopathy-and-therapeutic-hypothermia
#10
Naeem Mahfooz, Arie Weinstock, Bushra Afzal, Mariam Noor, David Vargas Lowy, Osman Farooq, Sarah G Finnegan, Satyan Lakshminrusimha
Continuous video-electroencephalography (EEG) is an important diagnostic and prognostic tool in newborns with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia. The optimal duration of continuous video-EEG during whole-body hypothermia is not known. We conducted a retrospective study of 35 neonates with hypoxic-ischemic encephalopathy undergoing whole-body hypothermia with continuous video-EEG. EEG ictal changes were detected in 9/35 infants (26%). Of these 9 infants, the seizures were initially observed within 30 minutes of EEG monitoring in 6 (67%), within 24 hours in 2 (22%), and during rewarming in 1 infant (11%)...
May 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28089767/the-correlation-between-a-short-term-conventional-electroencephalography-in-the-first-day-of-life-and-brain-magnetic-resonance-imaging-in-newborns-undergoing-hypothermia-for-hypoxic-ischemic-encephalopathy
#11
Rawad Obeid, Yoshimi Sogawa, Satyanarayana Gedela, Monica Naik, Vince Lee, Richard Telesco, Jessica Wisnowski, Christine Magill, Michael J Painter, Ashok Panigrahy
OBJECTIVE: Electroencephalograph recorded in the first day of life in newborns treated with hypothermia for hypoxic-ischemic encephalopathy could be utilized as a predictive tool for the severity of brain injury on magnetic resonance imaging and mortality. STUDY DESIGN: We analyzed newborns who were admitted for therapeutic hypothermia due to hypoxic-ischemic encephalopathy. All enrolled infants underwent encephalography within the first 24 hours of life and underwent brain magnetic resonance imaging after rewarming...
February 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28081533/eeg-monitoring-technique-influences-the-management-of-hypoxic-ischemic-seizures-in-neonates-undergoing-therapeutic-hypothermia
#12
Saber Jan, Frances J Northington, Charlamaine M Parkinson, Carl E Stafstrom
Electroencephalogram (EEG) monitoring techniques for neonatal hypoxia-ischemia (HI) are evolving over time, and the specific type of EEG utilized could influence seizure diagnosis and management. We examined whether the type of EEG performed affected seizure treatment decisions (e.g., the choice and number of antiseizure drugs [ASDs]) in therapeutic hypothermia-treated neonates with HI from 2007 to 2015 in the Johns Hopkins Hospital Neonatal Intensive Care Unit. During this period, 3 different EEG monitoring protocols were utilized: Period 1 (2007-2009), single, brief conventional EEG (1 h duration) at a variable time during therapeutic hypothermia treatment, i...
January 17, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28079874/cerebral-modulation-of-the-autonomic-nervous-system-in-term-infants
#13
N Schneebaum Sender, R B Govindan, M T Whitehead, A N Massaro, M Metzler, J Wang, Y I Cheng, A J du Plessis
OBJECTIVE: Central topography of autonomic nervous system (ANS) function has yet to be fully deciphered. In adults it has been shown to lateralize sympathetic and parasympathetic influence predominantly to the right and left cerebral hemispheres, respectively. We examined functional topography of central ANS in newborn subjects utilizing spectral analysis of heart rate variability (HRV), an established measure of ANS function. STUDY DESIGN: We studied newborns with hypoxic-ischemic encephalopathy participating in a prospective study undergoing a therapeutic hypothermia protocol...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27942508/urinary-gas-chromatography-mass-spectrometry-metabolomics-in-asphyxiated-newborns-undergoing-hypothermia-from-the-birth-to-the-first-month-of-life
#14
Antonio Noto, Giulia Pomero, Michele Mussap, Luigi Barberini, Claudia Fattuoni, Francesco Palmas, Cristina Dalmazzo, Antonio Delogu, Angelica Dessì, Vassilios Fanos, Paolo Gancia
BACKGROUND: Perinatal asphyxia is a severe clinical condition affecting around four million newborns worldwide. It consists of an impaired gas exchange leading to three biochemical components: hypoxemia, hypercapnia and metabolic acidosis. METHODS: The aim of this longitudinal experimental study was to identify the urine metabolome of newborns with perinatal asphyxia and to follow changes in urine metabolic profile over time. Twelve babies with perinatal asphyxia were included in this study; three babies died on the eighth day of life...
November 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27844484/golden-60%C3%A2-minutes-of-newborn-s-life-part-2-term-neonate
#15
Deepak Sharma, Pradeep Sharma, Sweta Shastri
The concept of "Golden 60 minutes" or "Golden Hour" has been derived from adult trauma. It has been defined as the first 60 min of postnatal life. It has been seen that care received by any newborn in the initial first hour has implications in the future life, showing the importance of golden hour. The major cause of neonatal mortality term newborn is asphyxia, which can be reduced with effective resuscitation. In golden hour approach for term newborn, the importance is given to effective and evidence based resuscitation, post-resuscitation care, delayed cord clamping, prevention of hypothermia, immediate breast feeding, prevention of hypoglycemia, and starting of therapeutic hypothermia in case of moderate to severe asphyxia...
November 29, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27749457/treatment-effects-on-neonatal-eeg
#16
REVIEW
Rawad Obeid, Tammy N Tsuchida
Conventional EEG and amplitude-integrated electroencephalography are used in neonates to assess prognosis and significant changes in brain activity. Neuroactive medications and hypothermia can influence brain activity and therefore alter EEG interpretation. There are limited studies on the effect of these therapies on neonatal EEG background activity. Medication effects on the EEG or amplitude-integrated electroencephalography include increased interburst interval duration, voltage suppression, and sleep disruption...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27698775/astragaloside-iv-ameliorates-necrotizing-enterocolitis-by-attenuating-oxidative-stress-and-suppressing-inflammation-via-the-vitamin-d3-upregulated-protein-1-nf-%C3%AE%C2%BAb-signaling-pathway
#17
Zhiyong Cai, Jindi Liu, Hongliang Bian, Jinlan Cai
Astragaloside IV (AS-IV) is a flavonoid from the plant Astragalus membranaceus (Fisch) Bge that has a wide range of therapeutic effects. The aim of the present study was to examine the effect of AS-IV on rats with necrotizing enterocolitis (NEC) under oxidative stress and inflammation. Newborn Sprague-Dawley rats were induced with NEC by asphyxia and hypothermia applied on 3 consecutive days. The rats were orally administered AS-IV at 25, 50 and 75 mg/kg for 4 days. The results revealed that AS-IV administration prevented NEC-induced decrease in the concentration of malondialdehyde and myeloperoxidase, and increase in the activity of glutathione (GSH) and superoxide dismutase in murine models...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27686886/neuroprotective-effects-of-cannabidiol-in-hypoxic-ischemic-insult-the-therapeutic-window-in-newborn-mice
#18
Nagat Mohammed, Maria Ceprián, Laura Jimenez, M Ruth Pazos, Jose Martínez-Orgado
BACKGROUND: A relevant therapeutic time window (TTW) is an important criterion for considering the clinical relevance of a substance preventing newborn hypoxic-ischemic (HI) brain damage. OBJECTIVE: to test the TTW of the neuroprotective effects of cannabidol (CBD), a non-psychoactive cannabinoid in a model of newborn HI brain damage. METHOD: 9-10 day-old C57BL6 mice underwent a HI insult (10% oxygen for 90 min after left carotid artery electrocoagulation)...
September 27, 2016: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/27616300/neuroprotective-effects-of-hypothermia-in-inflammatory-sensitized-hypoxic-ischemic-encephalopathy
#19
Mathilde Chevin, Clémence Guiraut, Caroline Maurice-Gelinas, Jessica Deslauriers, Sylvain Grignon, Guillaume Sébire
BACKGROUND: Despite the recent introduction of hypothermia as a mandatory standard of care, the incidence of neonatal encephalopathy in full-term newborns and its devastating neuro-behavioral outcomes continues to be a major individual, familial and social issue. Neonatal encephalopathy is mainly due to the compounding and interacting effects of hypoxia-ischemia and inflammation resulting from placental and other perinatal infections. It is unclear why hypothermia is effective in alleviating neonatal encephalopathy in some, but not all, full-term newborns...
December 2016: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/27583772/mild-hypothermia-facilitates-the-long-term-survival-of-newborn-cells-in-the-dentate-gyrus-after-traumatic-brain-injury-by-diminishing-a-pro-apoptotic-microenvironment
#20
Chong Chen, Tie-Zhu Ma, Li-Na Wang, Jing-Jing Wang, Yue Tu, Ming-Liang Zhao, Sai Zhang, Hong-Tao Sun, Xiao-Hong Li
Although previous research has demonstrated that traumatic brain injury (TBI) accelerates the proliferation of neural stem cells in dentate gyrus of the hippocampus, most of these newborn cells undergo apoptosis in a traumatic microenvironment. Thus, promoting the long-term survival of newborn cells during neurogenesis is a compelling goal for the treatment of TBI. In this study, we investigated whether mild hypothermia (MHT) therapy, which mitigates the multiple secondary injury cascades of TBI, enhances the survival of newborn cells...
October 29, 2016: Neuroscience
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