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Therapeutic hypothermia in newborn

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https://www.readbyqxmd.com/read/29775114/oxygen-dependency-of-mitochondrial-metabolism-indicates-outcome-of-newborn-brain-injury
#1
Gemma Bale, Subhabrata Mitra, Isabel de Roever, Magdalena Sokolska, David Price, Alan Bainbridge, Roxana Gunny, Cristina Uria-Avellanal, Giles S Kendall, Judith Meek, Nicola J Robertson, Ilias Tachtsidis
There is a need for a method of real-time assessment of brain metabolism during neonatal hypoxic-ischaemic encephalopathy (HIE). We have used broadband near-infrared spectroscopy (NIRS) to monitor cerebral oxygenation and metabolic changes in 50 neonates with HIE undergoing therapeutic hypothermia treatment. In 24 neonates, 54 episodes of spontaneous decreases in peripheral oxygen saturation (desaturations) were recorded between 6 and 81 h after birth. We observed differences in the cerebral metabolic responses to these episodes that were related to the predicted outcome of the injury, as determined by subsequent magnetic resonance spectroscopy derived lactate/N-acetyl-aspartate...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29769612/hypothermia-broadens-the-therapeutic-time-window-of-mesenchymal-stem-cell-transplantation-for-severe-neonatal-hypoxic-ischemic-encephalopathy
#2
So Yoon Ahn, Yun Sil Chang, Dong Kyung Sung, Se In Sung, Won Soon Park
Recently, we have demonstrated that concurrent hypothermia and mesenchymal stem cells (MSCs) transplantation synergistically improved severe neonatal hypoxic ischemic encephalopathy (HIE). The current study was designed to determine whether hypothermia could extend the therapeutic time window of MSC transplantation for severe neonatal HIE. To induce HIE, newborn rat pups were exposed to 8% oxygen for 2 h following unilateral carotid artery ligation on postnatal day (P) 7. After approving severe HIE involving >50% of the ipsilateral hemisphere volume, hypothermia (32 °C) for 2 days was started...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29731237/recent-advances-in-preclinical-and-clinical-multimodal-mr-in-the-newborn-brain
#3
Vicente Enguix, Yang Ding, Gregory A Lodygensky
Aside from injury identification, MRI of the newborn brain has given us insight into cortical and white matter development, identified windows of vulnerabilities, enabled the introduction of therapeutic hypothermia which has become the standard of care in neonatal asphyxia, and is fostering leapfrogging discoveries in the field of neuro-genetics. This article reviews the main advances in recent years in newborn brain imaging both in preclinical and clinical research.
April 30, 2018: Journal of Magnetic Resonance
https://www.readbyqxmd.com/read/29668681/a-longitudinal-1h-nmr-metabolomics-analysis-of-urine-from-newborns-with-hypoxic-ischemic-encephalopathy-undergoing-hypothermia-therapy-clinical-and-medical-legal-insights
#4
Emanuela Locci, Antonio Noto, Melania Puddu, Giulia Pomero, Roberto Demontis, Cristina Dalmazzo, Antonio Delogu, Vassilios Fanos, Ernesto d'Aloja, Paolo Gancia
Perinatal asphyxia is an event affecting around four million newborns worldwide. The 0.5 to 2 per 1000 of full term asphyxiated newborns suffer from hypoxic-ischemic encephalopathy (HIE), which is a frequent cause of death or severe disability and, as consequence, the most common birth injury claim for obstetrics, gynaecologists, and paediatricians. Perinatal asphyxia results from a compromised gas exchange that leads to hypoxemia, hypercapnia, and metabolic acidosis. In this work, we applied a metabolomics approach to investigate the metabolic profiles of urine samples collected from full term asphyxiated newborns with HIE undergoing therapeutic hypothermia (TH), with the aim of identifying a pattern of metabolites associated with HIE and to follow their modifications over time...
2018: PloS One
https://www.readbyqxmd.com/read/29660115/a-working-model-for-hypothermic-neuroprotection
#5
Guido Wassink, Joanne O Davidson, Christopher A Lear, Sandra E Juul, Frances Northington, Laura Bennet, Alistair J Gunn
Therapeutic hypothermia significantly improves survival without disability in near-term and full-term newborns with moderate-severe hypoxic-ischaemic encephalopathy. However, hypothermic neuroprotection is incomplete. The challenge now is to find ways to further improve outcomes. One major limitation to progress is that the specific mechanisms of hypothermia are only partly understood. Evidence supports the concept that therapeutic cooling suppresses multiple extracellular death signals, including intracellular pathways of apoptotic and necrotic cell death and inappropriate microglial activation...
April 16, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29648595/progesterone-as-a-postnatal-prophylactic-agent-for-encephalopathy-caused-by-prenatal-hypoxic-ischemic-insult
#6
Yoshimasa Kawarai, Hirokazu Tanaka, Tatsuya Kobayashi, Makio Shozu
Brain damage caused by hypoxic ischemic insult during the perinatal period causes hypoxic ischemic encephalopathies (HIEs). Therapeutic hypothermia is indicated for HIE, but since the therapeutic burden is large for its limited therapeutic effectiveness, another strategy is needed. Progesterone (P4) plays a neuroprotective role through the actions of its metabolite, allopregnanolone (Allo), on P4 receptor, GABA (γ-aminobutyric acid)A receptors or both. We examined the therapeutic potential of P4 using a newborn rat model of HIE...
April 10, 2018: Endocrinology
https://www.readbyqxmd.com/read/29556208/raised-plasma-neurofilament-light-protein-levels-are-associated-with-abnormal-mri-outcomes-in-newborns-undergoing-therapeutic-hypothermia
#7
Divyen K Shah, Vennila Ponnusamy, Jane Evanson, Olga Kapellou, Georgia Ekitzidou, Neelam Gupta, Paul Clarke, Adina T Michael-Titus, Ping K Yip
Aims and hypothesis: Hypoxic-ischemic encephalopathy (HIE) remains an important cause of death and disability in newborns. Mild therapeutic hypothermia (TH) is safe and effective; however, there are no tissue biomarkers available at the bedside to select babies for treatment. The aim of this study was to show that it is feasible to study plasma neurofilament light (NfL) levels from newborns and to evaluate their temporal course. Hypothesis: Raised plasma NFL protein levels from newborns who undergo TH after HIE are associated with abnormal MRI outcomes...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29519539/autonomic-dysfunction-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia-impairs-physiological-responses-to-routine-care-events
#8
Heather Campbell, Rathinaswamy B Govindan, Srinivas Kota, Tareq Al-Shargabi, Marina Metzler, Nickie Andescavage, Taeun Chang, Gilbert Vezina, Adre du Plessis, An N Massaro
OBJECTIVE: To evaluate whether infants with hypoxic-ischemic encephalopathy and evidence of autonomic dysfunction have aberrant physiological responses to care events that could contribute to evolving brain injury. STUDY DESIGN: Continuous tracings of heart rate (HR), blood pressure (BP), cerebral near infrared spectroscopy, and video electroencephalogram data were recorded from newborn infants with hypoxic-ischemic encephalopathy who were treated with hypothermia...
May 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29514165/high-dose-erythropoietin-for-asphyxia-and-encephalopathy-heal-a-randomized-controlled-trial-background-aims-and-study-protocol
#9
Sandra E Juul, Bryan A Comstock, Patrick J Heagerty, Dennis E Mayock, Amy M Goodman, Stephanie Hauge, Fernando Gonzalez, Yvonne W Wu
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) remains an important cause of neonatal death and frequently leads to significant long-term disability in survivors. Therapeutic hypothermia, while beneficial, still leaves many treated infants with lifelong disabilities. Adjunctive therapies are needed, and erythropoietin (Epo) has the potential to provide additional neuroprotection. OBJECTIVES: The aim of this study was to review the current incidence, mechanism of injury, and sequelae of HIE, and to describe a new phase III randomized, placebo-controlled trial of Epo neuroprotection in term and near-term infants with moderate to severe HIE treated with therapeutic hypothermia...
March 7, 2018: Neonatology
https://www.readbyqxmd.com/read/29510380/the-neuroprotective-effects-of-hypothermia-on-bilirubin-induced-neurotoxicity-in-vitro
#10
Nazli Kuter, Nese Aysit-Altuncu, Gurkan Ozturk, Eren Ozek
BACKGROUND: In high-risk newborns indirect hyperbilirubinemia can lead to acute bilirubin encephalopathy and kernicterus. Despite the current therapeutic modalities, preventing or reversing the neurotoxicity cannot be achieved in all infants. OBJECTIVE: To investigate the neuroprotective effects of hypothermia on bilirubin-induced toxicity in primary mouse neuronal cell cultures. METHODS: Hippocampal cell cultures, isolated from newborn mouse brains, were incubated with unconjugated bilirubin (UCB) at 3 days in vitro (DIV) and immediately exposed to varying degrees of hypothermia...
March 6, 2018: Neonatology
https://www.readbyqxmd.com/read/29506900/a-review-of-the-conundrum-of-mild-hypoxic-ischemic-encephalopathy-current-challenges-and-moving-forward
#11
Lina Chalak, Samantha Latremouille, Imran Mir, Pablo J Sánchez, Guilherme Sant'Anna
A review of the conundrum called mild hypoxic-ischemic encephalopathy (HIE) is provided. During the past decades, the definition of HIE has evolved to accommodate the short window of time required for the initiation of therapeutic hypothermia. Also, neurological evaluations have changed with the use of simpler staging systems that can be applied within the first 6 h of life. In this review, we discuss the challenges in the identification of newborns with "mild HIE" within 6 h after birth, the limitations in the existing early biomarkers of brain injury, and the current knowledge gaps in the long term neurodevelopmental outcomes of infants diagnosed with mild HIE...
May 2018: Early Human Development
https://www.readbyqxmd.com/read/29502880/pulmonary-hypertension-associated-with-hypoxic-ischemic-encephalopathy-antecedent-characteristics-and-comorbidities
#12
Satyan Lakshminrusimha, Seetha Shankaran, Abbot Laptook, Scott McDonald, Martin Keszler, Krisa Van Meurs, Ronnie Guillet, Sanjay Chawla, Beena G Sood, Sonia Bonifacio, Abhik Das, Rosemary D Higgins
OBJECTIVE: To determine the characteristics of term infants with persistent pulmonary hypertension of the newborn (PPHN) associated with moderate or severe hypoxic ischemic encephalopathy (HIE). METHODS: We compared infants with and without PPHN enrolled in 2 randomized trials of therapeutic hypothermia: the induced hypothermia trial of cooling to 33.5°C for 72 hours vs normothermia, and the "usual-care" arm (33.5°C for 72 hours) of the optimizing cooling trial...
May 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29479231/initiation-of-passive-cooling-at-referring-centre-is-most-predictive-of-achieving-early-therapeutic-hypothermia-in-asphyxiated-newborns
#13
Brigitte Lemyre, Linh Ly, Vann Chau, Anil Chacko, Nicholas Barrowman, Hilary Whyte, Steven P Miller
Objective: To identify factors associated with early initiation and achievement of therapeutic hypothermia (TH) in newborns with hypoxic-ischemic encephalopathy (HIE). Methods: Retrospective cohort study of newborns who received TH according to National Institute of Child Health and Human Development (NICHD) criteria in two academic level 3 Neonatal Intensive Care Units (NICU) between 2009 and 2013. All infants were transported by a neonatal transport team (NNTT)...
August 2017: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29466895/altered-plasma-type-gelsolin-and-amyloid-%C3%AE-in-neonates-with-hypoxic-ischaemic-encephalopathy-under-therapeutic-hypothermia
#14
Isabel Benavente-Fernandez, Juan J Ramos-Rodriguez, Carmen Infante-Garcia, Gema Jimenez-Gomez, Alfonso Lechuga-Sancho, Simon Lubian-Lopez, Monica Garcia-Alloza
Hypoxic-ischemic encephalopathy (HIE) is a severe neonatal complication responsible for ∼23% of all neonatal deaths. Also, 30-70% of these patients will suffer lifetime disabilities, including learning impairment, epilepsy or cerebral palsy. However, biomarkers for HIE screening, or monitoring disease progression are limited. Herein, we sought to evaluate the clinical usefulness of plasma-type gelsolin (pGSN) and amyloid-beta (Aβ) 40 and 42 as prognostic biomarkers for HIE. pGSN has been previously suggested as a feasible marker in other brain injuries and amyloid-beta 40 and 42 are classically assessed in neurodegenerative diseases...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29431594/re-feasibility-of-a-miniature-esophageal-heat-exchange-device-for-rapid-therapeutic-cooling-in-newborns-preliminary-investigations-in-a-piglet-model-by-dingley-et-al-ther-hypothermia-temp-manag-2018-8-36-44
#15
Stephanie Slisz, Rogelio Silva, Erik Kulstad
No abstract text is available yet for this article.
March 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29417166/diffusion-pseudonormalization-and-clinical-outcome-in-term-neonates-with-hypoxic-ischemic-encephalopathy
#16
Katsumi Hayakawa, Sachiko Koshino, Koichi Tanda, Akira Nishimura, Osamu Sato, Hiroyuki Morishita, Takaaki Ito
BACKGROUND: Pseudonormalization of diffusion-weighted magnetic resonance imaging (MRI) can lead to underestimation of brain injury in newborns with hypoxic-ischemic encephalopathy (HIE), posing a significant problem. We have noticed that some neonates show pseudonormalization negativity on diffusion-weighted imaging. OBJECTIVE: To compare pseudonormalization negativity with clinical outcomes. MATERIALS AND METHODS: Seventeen term neonates with moderate or severe HIE underwent therapeutic hypothermia...
February 7, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29276874/persistent-hyperglycemia-in-a-neonate-is-it-a-complication-of-therapeutic-hypothermia
#17
Hülya Özdemir, Aslı Memişoğlu, Zeynep Alp-Unkar, Baran Arcagök, Hülya Bilgen, Serap Turan, Eren Özek
Özdemir H, Memişoğlu A, Alp-Unkar Z, Arcagök B, Bilgen H, Turan S, Özek E. Persistent hyperglycemia in a neonate: Is it a complication of therapeutic hypothermia? Turk J Pediatr 2017; 59: 193-196. The aim of this report is to present a newborn with persistent hyperglycemia requiring insulin therapy as a possible complication of therapeutic hypothermia. A term appropriate for gestational age (AGA) female infant, was born by emergency cesarean section due to abruption of placenta and was resuscitated and intubated in the delivery room...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29242417/phase-changing-material-for-therapeutic-hypothermia-in-neonates-with-hypoxic-ischemic-encephalopathy-a-multi-centric-study
#18
Niranjan Thomas, Thangaraj Abiramalatha, Vishnu Bhat, Manoj Varanattu, Suman Rao, Sanjay Wazir, Leslie Lewis, Umamaheswari Balakrishnan, Srinivas Murki, Jaikrishnan Mittal, Ashish Dongara, Y N Prashantha, Somashekhar Nimbalkar
OBJECTIVE: To assess the feasibility and safety of cooling asphyxiated neonates using phase changing material based device across different neonatal intensive care units in India. DESIGN: Multi-centric uncontrolled clinical trial. SETTING: 11 level 3 neonatal units in India from November 2014 to December 2015. PARTICIPANTS: 103 newborn infants with perinatal asphyxia, satisfying pre-defined criteria for therapeutic hypothermia...
December 14, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/29241628/-care-of-the-newborn-with-perinatal-asphyxia-candidate-for-therapeutic-hypothermia-during-the-first-six-hours-of-life-in-spain
#19
Juan Arnaez, Alfredo Garcia-Alix, Sara Calvo, Simón Lubián-López
INTRODUCTION: The process of care and assistance from birth to the starting of therapeutic hypothermia (TH) is crucial in order to improve its effectiveness and prevent the worsening of hypoxic-ischaemic injury. METHODS: A national cross-sectional study carried out in 2015 by use of a questionnaire sent to all level iii units on the care of the newborn≥35 weeks gestation within the first hours of life after a perinatal asphyxia event. According to clinical practice guidelines, the quality of care was compared between the hospitals that carried out or did not carry out TH, and according to the level of care...
December 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29213143/lactate-as-an-early-predictor-of-psychomotor-development-in-neonates-with-asphyxia-receiving-therapeutic-hypothermia
#20
Renata Polackova, Dana Salounova, Lumir Kantor
AIMS: This prospective study aimed to evaluate the relationship between persistently elevated lactate values in the arterial blood of newborns with grade II and III hypoxic ischemic encephalopathy (treated with therapeutic hypothermia) and psychomotor development at 24 months. METHODS: 51 neonates of gestational age from 36 to 41 weeks receiving therapeutic hypothermia for moderate to severe hypoxic ischaemic encephalopathy had arterial blood lactate levels regularly analysed...
December 4, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
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