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Therapeutic hypothermia in newborn

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 minutes of postnatal life. It has been seen that care received by any newborn in the initial first hour have 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 15, 2016: Journal of Maternal-fetal & Neonatal Medicine
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
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
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
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...
September 9, 2016: International Journal of Developmental Neuroscience
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
C J Moon, Y A Youn, S K Yum, I K Sung
OBJECTIVE: This study aimed to examine changes in cytokines according to therapeutic hypothermia (TH) for newborn hypoxic ischemic encephalopathy (HIE). STUDY DESIGN: We studied 20 neonates who were admitted with a diagnosis of HIE in the neonatal intensive care unit. Cytokine concentration assay was carried out for neonates (n=12) who received TH and neonates (n=8) who were not treated with hypothermia by collecting blood sample at 12, 48 and 120 h after birth...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Blanca R Del Pozzo-Magaña, Nhung Ho
Subcutaneous fat necrosis of the newborn (SFN) is a rare form of panniculitis that can be complicated by hypercalcemia and nephrocalcinosis. We conducted a 20-year retrospective cohort study of 30 patients to describe the clinical characteristics of SFN and the prevalence of hypercalcemia and other complications. Hypoxia and therapeutic hypothermia (TH) seem to play an important role in the development of SFN. Hypercalcemia developed in 63% of patients, three of whom developed nephrocalcinosis. There is a need for well-controlled prospective studies to determine the natural history, prevalence, and incidence of complications of SFN...
August 30, 2016: Pediatric Dermatology
Ignacio M Larrayoz, Manuel Rey-Funes, Daniela S Contartese, Federico Rolón, Anibal Sarotto, Veronica B Dorfman, Cesar F Loidl, Alfredo Martínez
Hypothermia has been proposed as a therapeutic intervention for some retinal conditions, including ischemic insults. Cold exposure elevates expression of cold-shock proteins (CSP), including RNA-binding motif protein 3 (RBM3) and cold inducible RNA-binding protein (CIRP), but their presence in mammalian retina is so far unknown. Here we show the effects of hypothermia on the expression of these CSPs in retina-derived cell lines and in the retina of newborn and adult rats. Two cell lines of retinal origin, R28 and mRPE, were exposed to 32°C for different time periods and CSP expression was measured by qRT-PCR and Western blotting...
2016: PloS One
Subhabrata Mitra, Gemma Bale, Judith Meek, Cristina Uria-Avellanal, Nicola J Robertson, Ilias Tachtsidis
Therapeutic hypothermia (TH) has become a standard of care following hypoxic ischemic encephalopathy (HIE). After TH, body temperature is brought back to 37 °C over 14 h. Lactate/N-acetylasperatate (Lac/NAA) peak area ratio on proton magnetic resonance spectroscopy ((1)H MRS) is the best available outcome biomarker following HIE. We hypothesized that broadband near infrared spectroscopy (NIRS) measured changes in the oxidation state of cytochrome-c-oxidase concentration (Δ[oxCCO]) and cerebral hemodynamics during rewarming would relate to Lac/NAA...
2016: Advances in Experimental Medicine and Biology
Sumio Fukuda, Tomoshige Tanimura, Toshihiko Iwaki, Machiko Higuchi, Megumi Suyama, Tomoki Goto, Wakato Koide, Kanemasa Maki, Katsumi Ushijima, Kyoko Ban
The purpose of this study was to determine the accuracy of mean blood flow velocity (mean V) in the internal carotid artery (ICA) for prediction of outcome in infants with hypoxic-ischemic encephalopathy (HIE) exposed to therapeutic hypothermia (TH). Five newborns with HIE who met the criteria for TH were enrolled. Ultrasonography of the right and left ICA was performed before, during, and after TH. Mean V of the sampling point in each ICA was measured. Mean V was suppressed during TH and increased after rewarming in four infants with normal neurological development...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Michael Sgro, Douglas M Campbell, Neil Gandhi
The case presented advocates for prolonged resuscitation, and aggressive rewarming in neonates with severe hypothermia (core temperature <32.0°C). The importance of rewarming has not been extensively studied in current guidelines, whereas the importance of cardiopulmonary resuscitation is well established. This abandoned, severely hypothermic (found with temperature of 27.9°C) newborn had an excellent neurological outcome at two years of age with aggressive resuscitation and rewarming techniques initiated at the time of presentation...
May 2016: Paediatrics & Child Health
Ana Beatriz C G Silva, Joanna Laszczyk, Luiz C Wrobel, Fernando L B Ribeiro, Andrzej J Nowak
This paper presents a thermoregulation finite element model (FEM) to simulate hypothermia procedures for the treatment of encephalopathy hypoxic-ischemia (EHI) in neonates, a dangerous ischemic condition that can cause neurological damages and even death. Therapeutic hypothermia is the only recommended technique to reduce sequels caused by EHI in neonates; intervention with moderate cooling for neural rescue in newborns with hypoxic-ischemic brain injury is the culmination of a series of clinical research studies spanning decades...
September 2016: Medical Engineering & Physics
Patricia Thorsen, Martine C Jansen-van der Weide, Floris Groenendaal, Wes Onland, Henrika L M van Straaten, Inge Zonnenberg, Jeroen R Vermeulen, Peter H Dijk, Jeroen Dudink, Monique Rijken, Arno van Heijst, Koen P Dijkman, Filip Cools, Alexandra Zecic, Anton H van Kaam, Timo R de Haan
BACKGROUND: The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score was developed before the use of therapeutic hypothermia, its value was reassessed. OBJECTIVE: The purpose of this study was to assess the association of the Thompson encephalopathy score with adverse short-term outcomes, defined as death before discharge, development of severe epilepsy, or the presence of multiple organ failure in asphyxiated newborns undergoing therapeutic hypothermia...
July 2016: Pediatric Neurology
Siv Fredly, Cathrine S Nygaard, Janne H Skranes, Tom Stiris, Drude Fugelseth
BACKGROUND: Therapeutic hypothermia is presumed to suppress inflammatory processes after perinatal asphyxia. In a previous study of neonatal hypoxic-ischemic encephalopathy (HIE) we found altered skin microcirculation in about a third of the infants after rewarming. We speculated whether this could be linked to increased inflammatory responses, such as high C-reactive protein (CRP). The present study further explored this question. OBJECTIVE: The aim of this study was to explore the differences in skin microcirculation and its oxygen delivery ability during cooling and after rewarming in HIE infants with or without high CRP...
2016: Neonatology
R B Govindan, Srinivas Kota, Tareq Al-Shargabi, An N Massaro, Taeun Chang, Adre du Plessis
BACKGROUND: Electroencephalogram (EEG) signals are often contaminated by the electrocardiogram (ECG) interference, which affects quantitative characterization of EEG. NEW METHOD: We propose null-coherence, a frequency-based approach, to attenuate the ECG interference in EEG using simultaneously recorded ECG as a reference signal. After validating the proposed approach using numerically simulated data, we apply this approach to EEG recorded from six newborns receiving therapeutic hypothermia for neonatal encephalopathy...
September 1, 2016: Journal of Neuroscience Methods
Elisa Milanesi, Cristina Loda, Bruno Drera, Carlo Poggiani
No abstract text is available yet for this article.
August 2016: Minerva Pediatrica
Adam Frymoyer, Sonia L Bonifacio, David R Drover, Felice Su, Courtney J Wustoff, Krisa P Van Meurs
Morphine is commonly used in neonates with hypothermic ischemic encephalopathy (HIE) during therapeutic hypothermia to provide comfort and analgesia. However, pharmacokinetic data to support morphine dosing in this vulnerable population are lacking. A prospective, two-center, clinical pharmacokinetic study of morphine was conducted in 20 neonates (birthweight 1.82-5.3 kg) with HIE receiving hypothermia. Morphine dosing was per standard of care at each center. Morphine and glucuronide metabolites (morphine-3-glucuronide and morphine-6-gluronide) were measured via a validated dried blood spot LC-MS/MS assay...
May 26, 2016: Journal of Clinical Pharmacology
Francesco Pisani, Carlotta Spagnoli
Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders.Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor phenomena, hypoxic-ischaemic encephalopathy, white matter injury of prematurity and stroke require specific approaches to diagnosis...
2016: Italian Journal of Pediatrics
Shoichiro Tanaka, Sachiko Iwata, Masahiro Kinoshita, Kennosuke Tsuda, Sayaka Sakai, Mamoru Saikusa, Ryota Shindo, Eimei Harada, Junichiro Okada, Tadashi Hisano, Hiroshi Kanda, Yasuki Maeno, Yuko Araki, Kazuo Ushijima, Teruo Sakamoto, Yushiro Yamashita, Osuke Iwata
Adult patients frequently suffer from serious respiratory complications during therapeutic hypothermia. During therapeutic hypothermia, respiratory gases are humidified close to saturated vapor at 37°C (44 mg/L) despite that saturated vapor reduces considerably depending on temperature reduction. Condensation may cause serious adverse events, such as bronchial edema, mucosal dysfunction, and ventilator-associated pneumonia during cooling. To determine clinical variables associated with inadequate humidification of respiratory gases during cooling, humidity of inspiratory gases was measured in 42 cumulative newborn infants who underwent therapeutic hypothermia...
December 2016: Therapeutic Hypothermia and Temperature Management
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