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Therapeutic hypothermia in newborn

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https://www.readbyqxmd.com/read/28867032/-revelation-of-the-circumstances-of-the-accident-vascular-arterial-ischemic-brain-in-at-term-or-near-term-and-referral
#1
F Cneude, J-F Diependaele, J-L Chabernaud
The neonatal arterial ischemic stroke is an emergency. Recurrent focal seizures, generally occurring in the first 24-72 hours after birth, are the commonest first clinical signs. When neonatal arterial ischemic stroke is suspected, optimal initial management involves careful supportive care including treatment of clinical and frequent or prolonged subclinical seizures, correction of the possible metabolic disorders and their prevention. Contrary to hypoxic ischemic encephalopathy, therapeutic hypothermia is not indicated...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28860214/brain-temperature-is-increased-during-the-first-days-of-life-in-asphyxiated-newborns-developing-brain-injury-despite-hypothermia-treatment
#2
Z P Owji, G Gilbert, C Saint-Martin, P Wintermark
BACKGROUND AND PURPOSE: Therapeutic hypothermia is the current treatment for neonates with hypoxic-ischemic encephalopathy. It is believed to work by decreasing the brain temperature and reducing the baseline metabolism and energy demand of the brain. This study aimed to noninvasively assess brain temperature during the first month of life in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. MATERIALS AND METHODS: Neonates with hypoxic-ischemic encephalopathy treated with hypothermia and healthy neonates were enrolled prospectively...
August 31, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28822711/efficacy-of-passive-hypothermia-and-adverse-events-during-transport-of-asphyxiated-newborns-according-to-the-severity-of-hypoxic-ischemic-encephalopathy
#3
Nuria Carreras, Miguel Alsina, Ana Alarcon, Gemma Arca-Díaz, Thais Agut, Alfredo García-Alix
OBJECTIVE: To determine if the efficacy of passive hypothermia and adverse events during transport are related to the severity of neonatal hypoxic-ischemic encephalopathy. METHODS: This was a retrospective study of 67 infants with hypoxic-ischemic encephalopathy, born between April 2009 and December 2013, who were transferred for therapeutic hypothermia and cooled during transport. RESULTS: Fifty-six newborns (84%) were transferred without external sources of heat and 11 (16%) needed an external heat source...
August 18, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28811085/the-use-of-phenobarbital-and-other-anti-seizure-drugs-in-newborns
#4
REVIEW
Mohamed El-Dib, Janet S Soul
Neonatal seizures constitute the most frequent presenting neurologic sign encountered in the neonatal intensive care unit. Despite limited efficacy and safety data, phenobarbital continues to be used near-universally as the first-line anti-seizure drug (ASD) in neonates. The choice of second-line ASDs varies by provider and institution, and is still not supported by sufficient scientific evidence. In this review, we discuss the available evidence supporting the efficacy, mechanism of action, potential adverse effects, key pharmacokinetic characteristics such as interaction with therapeutic hypothermia, logistical issues, and rationale for use of neonatal ASDs...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28800288/population-based-study-of-the-national-implementation-of-therapeutic-hypothermia-in-infants-with-hypoxic-ischemic-encephalopathy
#5
Juan Arnaez, Alfredo García-Alix, Gemma Arca, Sonia Caserío, Eva Valverde, M Teresa Moral, Isabel Benavente-Fernández, Simón Lubián-López
Data on the incidence of hypoxic-ischemic encephalopathy (HIE) in the first 6 hours of life together with the implementation of therapeutic hypothermia (TH) are relevant to delineate actions to achieve the lowest rates of neonatal mortality, morbidity, and long-term impact on health associated with HIE. This is population-based national survey study, including newborns ≥35 weeks of gestation with moderate-to-severe HIE from all level III neonatal care units, to provide the incidence of HIE for the period 2012-2013, and the implementation of TH up to June 2015 in Spain...
August 11, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28764944/-incidence-of-hypoxic-ischaemic-encephalopathy-and-use-of-therapeutic-hypothermia-in-spain
#6
Juan Arnaez, Alfredo García-Alix, Gemma Arca, Eva Valverde, Sonia Caserío, M Teresa Moral, Isabel Benavente-Fernández, Simón Lubián-López
INTRODUCTION: There are no data on the incidence of hypoxic-ischaemic encephalopathy (HIE) and the implementation of therapeutic hypothermia (TH) in Spain. METHODS: This is a cross-sectional, national study, performed using an on-line questionnaire targeting level III neonatal care units in Spain. Participants were requested to provide data of all newborns ≥ 35 weeks of gestational age diagnosed with moderate-severe HIE over a two year-period (2012-2013), and of the implementation of TH up to June 2015...
July 29, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28629243/effect-of-therapeutic-hypothermia-on-myocardial-dysfunction-in-term-neonates-with-perinatal-asphyxia-a-randomized-controlled-trial
#7
K Rakesh, B Vishnu Bhat, B Adhisivam, P Ajith
OBJECTIVE: To evaluate the effect of therapeutic hypothermia on myocardial dysfunction in term neonates with perinatal asphyxia. MATERIAL AND METHODS: This randomized controlled trial (RCT) conducted in a tertiary care teaching hospital, south India included 120 newborns with perinatal asphyxia that were randomized to two groups (therapeutic hypothermia and normothermia). Cardiac enzyme profile changes between groups were assessed at 0, 24, 72 h CPK-MB and troponin I levels were estimated by immune inhibition and quantitative immunochromatography methods, respectively...
July 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28619605/the-prognostic-value-of-proton-magnetic-resonance-spectroscopy-in-term-newborns-treated-with-therapeutic-hypothermia-following-asphyxia
#8
Paul E Sijens, Katharina Wischniowsky, Hendrik J Ter Horst
OBJECTIVE: The purpose of this study was to correlate brain metabolism assessed shortly after therapeutic hyperthermia by (1)H magnetic resonance spectroscopy (MRS), with neurodevelopmental outcome. METHODS: At the age of 6.0±1.8days, brain metabolites of 35 term asphyxiated newborns, treated with therapeutic hypothermia, were quantified by multivoxel proton MRS of a volume cranial to the corpus callosum, containing both gray and white matter. At the age of 30months the Bayley Scale of Infant Development-III was performed...
June 12, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28617423/relationship-between-temperature-variability-and-brain-injury-on-magnetic-resonance-imaging-in-cooled-newborn-infants-after-perinatal-asphyxia
#9
B Brotschi, R Gunny, C Rethmann, U Held, B Latal, C Hagmann
OBJECTIVE: The objective of the study was whether temperature management during therapeutic hypothermia correlates with the severity of brain injury assessed on magnetic resonance imaging in term infants with hypoxic-ischemic encephalopathy. STUDY DESIGN: Prospectively collected register data from the National Asphyxia and Cooling Register of Switzerland were analyzed. RESULT: Fifty-five newborn infants were cooled for 72 h with a target temperature range of 33 to 34 °C...
September 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28573895/impacts-of-therapeutic-hypothermia-on-cardiovascular-hemodynamics-in-newborns-with-hypoxic-ischemic-encephalopathy-a-case-control-study-using-echocardiography
#10
Ji Hong Yoon, Eun-Jung Lee, Sook Kyung Yum, Cheong-Jun Moon, Young-Ah Youn, Yoo Jin Kwun, Jae Young Lee, In Kyung Sung
PURPOSE: The effects of therapeutic hypothermia (TH) on hemodynamics in newborns with hypoxic-ischemic encephalopathy (HIE) were evaluated. MATERIALS AND METHODS: Thirty-two neonates (gestational age, 39.4 ± 1.3 weeks) who had TH for HIE and echocardiographic hemodynamic assessments during TH and post-TH period were studied. Gestational-age-matched 34 healthy neonates were enrolled for comparison. RESULTS: During TH, patients had significantly decreased left ventricular cardiac output (LVCO), descending aorta blood flow (DABF), and DABF/LVCO ratio, and increased resistive index of DA compared to controls...
July 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28567061/therapeutic-hypothermia-in-asphyxiated-neonates-experience-from-neonatal-intensive-care-unit-of-university-hospital-of-marrakech
#11
F M R Maoulainine, M Elbaz, S Elfaiq, G Boufrioua, F Z Elalouani, M Barkane, Nadia El Idrissi Slitine
INTRODUCTION: Therapeutic hypothermia (TH) is now recommended for the treatment neonates with hypoxic-ischemic encephalopathy (HIE). This treatment protocol is applied in our department since June 2012. The aim of this study is to report the first experience with head cooling in asphyxiated neonates in Morocco. PATIENTS AND METHODS: Prospective study of newborns admitted for HIE from July 18, 2012, to May 15, 2014, in Neonatal Intensive Care Unit (NICU) of Mohamed VI University Hospital...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28556862/therapeutic-hypothermia-to-treat-a-newborn-with-perinatal-hypoxic-ischemic-encephalopathy
#12
Todd R Fredricks, Christopher Gibson, Francis Essien, Jeffrey S Benseler
Hypoxic-ischemic encephalopathy is caused by neonatal asphyxia and can lead to mortality or long-term neurodevelopmental morbidity in neonates. Therapeutic hypothermia (TH) is one of the few effective ways to manage mitigating neurologic sequelae. The authors describe the case of a neonate who had a perinatal hypoxic insult and sustained no long-term sequelae after being treated with TH. It is important that osteopathic physicians who provide obstetric and gynecologic, perinatal, and emergency medical care are able to recognize a perinatal hypoxic event, understand the stratification of hypoxic-ischemic encephalopathy risk factors, and implement early TH protocols...
June 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28512388/insufficient-humidification-of-respiratory-gases-in-patients-who-are-undergoing-therapeutic-hypothermia-at-a-paediatric-and-adult-intensive-care-unit
#13
Yukari Tanaka, Sachiko Iwata, Masahiro Kinoshita, Kennosuke Tsuda, Shoichiro Tanaka, Naoko Hara, Ryota Shindou, Eimei Harada, Ryouji Kijima, Osamu Yamaga, Hitoe Ohkuma, Kazuo Ushijima, Teruo Sakamoto, Yushiro Yamashita, Osuke Iwata
For cooled newborn infants, humidifier settings for normothermic condition provide excessive gas humidity because absolute humidity at saturation is temperature-dependent. To assess humidification of respiratory gases in patients who underwent moderate therapeutic hypothermia at a paediatric/adult intensive care unit, 6 patients were studied over 9 times. Three humidifier settings, 37-default (chamber-outlet, 37°C; Y-piece, 40°C), 33.5-theoretical (chamber-outlet, 33.5°C; Y-piece, 36.5°C), and 33.5-adjusted (optimised setting to achieve saturated vapour at 33...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28504509/-recommendation-for-therapeutic-hypothermia-in-newborns-with-hypoxic-ischemic-encephalopathy-executive-summary
#14
(no author information available yet)
No abstract text is available yet for this article.
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28471439/relationships-between-cerebral-autoregulation-and-markers-of-kidney-and-liver-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#15
J K Lee, J Perin, C Parkinson, M O'Connor, M M Gilmore, M Reyes, J Armstrong, J M Jennings, F J Northington, R Chavez-Valdez
OBJECTIVE: We studied whether cerebral blood pressure autoregulation and kidney and liver injuries are associated in neonatal encephalopathy (NE). STUDY DESIGN: We monitored autoregulation of 75 newborns who received hypothermia for NE in the neonatal intensive care unit to identify the mean arterial blood pressure with optimized autoregulation (MAPOPT). Autoregulation parameters and creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were analyzed using adjusted regression models...
August 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28443558/towards-evidence-based-resuscitation-of-the-newborn-infant
#16
REVIEW
Brett J Manley, Louise S Owen, Stuart B Hooper, Susan E Jacobs, Jeanie L Y Cheong, Lex W Doyle, Peter G Davis
Effective resuscitation of the newborn infant has the potential to save many lives around the world and reduce disabilities in children who survive peripartum asphyxia. In this Series paper, we highlight some of the important advances in the understanding of how best to resuscitate newborn infants, which includes monitoring techniques to guide resuscitative efforts, increasing awareness of the adverse effects of hyperoxia, delayed umbilical cord clamping, the avoidance of routine endotracheal intubation for extremely preterm infants, and therapeutic hypothermia for hypoxic-ischaemic encephalopathy...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#17
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
#18
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
#19
Marina Metzler, Rathinaswamy Govindan, Tareq Al-Shargabi, Gilbert Vezina, Nickie Andescavage, Yunfei Wang, Adre du Plessis, An N Massaro
BackgroundDecreased 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 using magnetic resonance imaging (MRI) in newborns with HIE undergoing therapeutic hypothermia.MethodsHRV metrics were quantified in the time domain (αS, αL, and root mean square at short (RMSS) and long (RMSL) timescales) and frequency domain (relative low-(LF) and high-frequency (HF) power) over 24-27 h of life...
September 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
#20
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...
2017: Developmental Neuroscience
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