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neonatal therapeutic hypothermia

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https://www.readbyqxmd.com/read/29341043/can-neonatal-brain-mri-be-performed-during-active-cooling
#1
Marisa J Pacella, Dhanashree A Rajderkar, Nicole Copenhaver, Kristine Boykin, Michael D Weiss
OBJECTIVE:  Due to logistical constraints, physicians traditionally delay diagnostic imaging for neonatal hypoxic-ischemic encephalopathy (HIE) until the neonate has completed all 72 hours of therapeutic hypothermia and rewarming. In some cases, neonates may require neuroimaging before 72 hours has passed. STUDY DESIGN:  We present a case in which an MRI was acquired during active hypothermia. RESULTS:  Upon return to the NICU, Baby X's temperature probe read 33...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29339173/neuroprotective-effects-of-topiramate-and-memantine-in-combination-with-hypothermia-in-hypoxic-ischemic-brain-injury-in-vitro-and-in-vivo
#2
Elisa Landucci, Luca Filippi, Elisabetta Gerace, Serena Catarzi, Renzo Guerrini, Domenico E Pellegrini-Giampietro
Hypoxic-ischemic encephalopathy (HIE) is a major cause of perinatal mortality and subsequent severe neurological sequelae. Mild hypothermia is a standard therapy for HIE, but is used only in selected Reference Centers and in neonates >1800 g. Since neuronal death following HIE occurs by a cascade of events triggered by activation of glutamate receptors, we used in vitro and in vivo models of HIE to examine whether the AMPA/kainate receptor antagonist topiramate and the NMDA receptor antagonist memantine could exert neuroprotective effects, alone or in combination with hypothermia...
January 12, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29276874/persistent-hyperglycemia-in-a-neonate-is-it-a-complication-of-therapeutic-hypothermia
#3
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/29275405/neonatal-systemic-inflammation-induces-inflammatory-reactions-and-brain-apoptosis-in-a-pathogen-specific-manner
#4
Mari Falck, Damjan Osredkar, Thomas Ragnar Wood, Elke Maes, Torun Flatebø, Hemmen Sabir, Marianne Thoresen
BACKGROUND: After neonatal asphyxia, therapeutic hypothermia (HT) is the only proven treatment option. Although established as a neuroprotective therapy, benefit from HT has been questioned when infection is a comorbidity to hypoxic-ischaemic (HI) brain injury. Gram-negative and gram-positive species activate the immune system through different pathogen recognition receptors and subsequent immunological systems. In rodent models, gram-negative (lipopolysaccharide [LPS]) and gram-positive (PAM3CSK4 [PAM]) inflammation similarly increase neuronal vulnerability to HI...
December 23, 2017: Neonatology
https://www.readbyqxmd.com/read/29242417/phase-changing-material-for-therapeutic-hypothermia-in-neonates-with-hypoxic-ischemic-encephalopathy-a-multi-centric-study
#5
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/29234304/hypothesis-on-the-role-of-cryptochromes-in-inflammation-and-subarachnoid-hemorrhage-outcome
#6
Adriano Barreto Nogueira, Ariel Barreto Nogueira, José Carlos Esteves Veiga, Manoel Jacobsen Teixeira
We have recently found that the temperature variability (TV) in the day-night cycle may predict the mean intracranial pressure in the following 24 h (ICP24) in subarachnoid hemorrhage (SAH) patients under multimodality monitoring, sedation, and hypothermia (<35°C). Specifically, we found that ICP24 = 6 (4 - TV) mmHg. TV is the ratio between the coefficient of variation of temperature during the nocturnal and the preceding diurnal periods. This result suggests that the circadian clock reflects brain plasticity mechanisms and its malfunctioning leads to deterioration of the neurologic status...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29232903/pediatric-thermal-burns-and-treatment-a-review-of-progress-and-future-prospects
#7
REVIEW
Elton Mathias, Madhu Srinivas Murthy
Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population...
December 11, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29228894/is-therapeutic-hypothermia-during-neonatal-extracorporeal-membrane-oxygenation-associated-with-intracranial-hemorrhage
#8
Katherine Cashen, Ron W Reeder, Christina Shanti, Heidi J Dalton, J Michael Dean, Kathleen L Meert
INTRODUCTION: The use of therapeutic hypothermia during neonatal extracorporeal membrane oxygenation (ECMO) as a neurologic protective strategy has gained interest among clinicians despite limited data. Our objective is to describe the relationship between the use of therapeutic hypothermia during neonatal ECMO and complications, mortality and functional status among survivors. METHODS: Secondary analysis of data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29217807/therapeutic-hypothermia-for-neonatal-encephalopathy-in-indian-neonatal-units-a-survey-of-national-practices
#9
Manigandan Chandrasekaran, Ravi Swamy, Siddarth Ramji, Seetha Shankaran, Sudhin Thayyil
This cross-sectional web-based survey suggests that cooling therapy is offered as standard of care for babies with neonatal encephalopathy in 10/25 (40%) of public and 37/68 (51%) of private level 2 or 3 neonatal units in India. 25 (53%) used locally improvised cooling methods, and the cooling practices differed from established protocols in high-income countries.
November 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/29213143/lactate-as-an-early-predictor-of-psychomotor-development-in-neonates-with-asphyxia-receiving-therapeutic-hypothermia
#10
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
https://www.readbyqxmd.com/read/29196306/perinatal-infratentorial-haemorrhage-a-rare-but-possibly-life-threatening-condition
#11
Bettina Cornelia Henzi, Bendicht Wagner, Rajeev Kumar Verma, Sandra Bigi
BACKGROUND: Perinatal infratentorial haemorrhage (PIH) is a rare birth complication associated with abnormal labour. CASE PRESENTATION: A baby boy was born by vacuum extraction at 41 weeks' gestational age. The pregnancy was uneventful and Apgar scores were 3/6/9. Following initial resuscitation, insufficient and irregular breathing, non-reactive pupils and absence of spontaneous movements were noted. A diagnosis of perinatal asphyxia with hypoxic-ischaemic encephalopathy (HIE) was considered...
December 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29182481/the-use-of-therapeutic-hypothermia-in-neonates-with-perinatal-asphyxia-at-charlotte-maxeke-johannesburg-academic-hospital-a-retrospective-review
#12
Khutso N Sebetseba, Tanusha Ramdin, Daynia Ballot
Therapeutic hypothermia (TH) has become the standard of care to reduce neurological damage following perinatal asphyxia. Current recommendations call for implementation of a standard, evidence-based protocol for the provision of TH. This is particularly challenging in resource-limited settings. This is a retrospective, descriptive study to determine whether neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) are receiving TH according to the unit protocol in place. The study included all neonates with a birth weight greater than 1800 g admitted to the CMJAH neonatal unit from January 1, 2013, to June 30, 2017, before 24 hours of life...
November 28, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29172116/bilateral-loss-of-cortical-seps-predict-severe-mri-lesions-in-neonatal-hypoxic-ischemic-encephalopathy-treated-with-hypothermia
#13
Agnese Suppiej, Ambra Cappellari, Giacomo Talenti, Elisa Cainelli, Matteo Di Capua, Augusta Janes, Daniela Longo, Rodica Mardari, Cristina Marinaccio, Stefano Pro, Paola Sciortino, Daniele Trevisanuto, Roberta Vittorini, Renzo Manara
OBJECTIVE: The introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). METHODS: Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4-14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20)...
November 6, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29171918/asphyxiated-neonates-who-received-active-therapeutic-hypothermia-during-transport-had-higher-rates-of-hypocapnia-than-controls
#14
Eniko Szakmar, Kata Kovacs, Unoke Meder, Geza Bokodi, Andras Szell, Zsolt Somogyvari, Attila J Szabo, Miklos Szabo, Agnes Jermendy
AIM: We investigated the association between active hypothermia and hypocapnia in neonates with moderate to severe hypoxic-ischaemic encephalopathy (HIE) transported after birth. METHODS: This was a retrospective cohort study of neonates with HIE born between 2007-2011 and transported to Semmelweis University, Hungary, for hypothermia treatment before and after we introduced active cooling during transport in 2009. Of these, 71 received intensive care plus controlled active hypothermia during transport, while the 46 controls just received standard intensive care...
November 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29165765/hypothermia-in-neonatal-hypoxic-ischemic-encephalopathy-hie
#15
G Liu, Z-G Li, J-S Gao
Neonatal hypoxic-ischemic encephalopathy (HIE) significantly affects neurodevelopment in infants and is also considered as an important cause of neonatal deaths worldwide. Medical research is being focused worldwide for the development of therapeutic avenues but it is still managed by supportive care. The latest studies in the above field have shown the efficacy of prolonged cooling of neonate's head or whole body at the age of 18 months (approx.) in providing relief from the pathological state of HIE. Moreover, hypothermia is the first reported therapeutic modality that proved beneficial for HIE young patients...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29138115/active-forms-of-akt-and-erk-are-dominant-in-the-cerebral-cortex-of-newborn-pigs-that-are-unaffected-by-asphyxia
#16
Viktória Kovács, Valéria Tóth-Szűki, János Németh, Viktória Varga, Gábor Remzső, Ferenc Domoki
AIMS: Perinatal asphyxia (PA) often results in hypoxic-ischemic encephalopathy (HIE) in term neonates. Introduction of therapeutic hypothermia improved HIE outcome, but further neuroprotective therapies are still warranted. The present study sought to determine the feasibility of the activation of the cytoprotective PI-3-K/Akt and the MAPK/ERK signaling pathways in the subacute phase of HIE development in a translational newborn pig PA/HIE model. MAIN METHODS: Phosphorylated and total levels of Akt and ERK were determined by Western blotting in brain samples obtained from untreated naive, time control, and PA/HIE animals at 24-48h survival (n=3-3-6,respectively)...
November 11, 2017: Life Sciences
https://www.readbyqxmd.com/read/29108501/occult-massive-visceral-fat-necrosis-following-therapeutic-hypothermia-for-neonatal-encephalopathy
#17
Salwa Khedr, Anna Piskorski, Adrienne R Bingham, Justin Goldstein, Abbot R Laptook, Monique E De Paepe
Therapeutic hypothermia (head or whole-body cooling) improves survival and neurodevelopmental outcome in term newborns with moderate-to-severe encephalopathy. Hypothermia treatment is well tolerated; the most common side effect is thrombocytopenia. In about 1% of infants, focal subcutaneous fat necrosis has been reported. We describe a case of clinically unsuspected massive visceral fat necrosis in a term infant with Apgar score 0 at 1 min ("resuscitated apparently stillborn" infant) who was treated with therapeutic hypothermia for 72 h and expired on the 25th day of life following a neonatal course complicated by severe encephalopathy, pulmonary artery hypertension, persistent thrombocytopenia, hypoglycemia, and severe basal ganglia-thalamic abnormalities on magnetic resonance imaging...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29095291/relevance-of-urinary-s100b-protein-levels-as-a-short-term-prognostic-biomarker-in-asphyxiated-infants-treated-with-hypothermia
#18
Ayham Alshweki, Alejandro Pérez-Muñuzuri, Olalla López-Suárez, Ana Baña, Maria L Couce
The initial diagnosis of neonatal hypoxic-ischemic encephalopathy is based on nervous system clinical manifestations. The use of biomarkers to monitor brain injury and evaluate neuroprotective effects allows early intervention and treatment. This study was designed to determine the short-term prognostic significance of urinary S100B calcium-binding protein (S100B) in asphyxiated newborns treated with hypothermia.An observational prospective study was conducted over a period of 5 years in 31 newborns with hypoxic-ischemic encephalopathy who received therapeutic hypothermia...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29067428/effect-of-therapeutic-hypothermia-initiated-after-6-hours-of-age-on-death-or-disability-among-newborns-with-hypoxic-ischemic-encephalopathy-a-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Abbot R Laptook, Seetha Shankaran, Jon E Tyson, Breda Munoz, Edward F Bell, Ronald N Goldberg, Nehal A Parikh, Namasivayam Ambalavanan, Claudia Pedroza, Athina Pappas, Abhik Das, Aasma S Chaudhary, Richard A Ehrenkranz, Angelita M Hensman, Krisa P Van Meurs, Lina F Chalak, Shannon E G Hamrick, Gregory M Sokol, Michele C Walsh, Brenda B Poindexter, Roger G Faix, Kristi L Watterberg, Ivan D Frantz, Ronnie Guillet, Uday Devaskar, William E Truog, Valerie Y Chock, Myra H Wyckoff, Elisabeth C McGowan, David P Carlton, Heidi M Harmon, Jane E Brumbaugh, C Michael Cotten, Pablo J Sánchez, Anna Maria Hibbs, Rosemary D Higgins
Importance: Hypothermia initiated at less than 6 hours after birth reduces death or disability for infants with hypoxic-ischemic encephalopathy at 36 weeks' or later gestation. To our knowledge, hypothermia trials have not been performed in infants presenting after 6 hours. Objective: To estimate the probability that hypothermia initiated at 6 to 24 hours after birth reduces the risk of death or disability at 18 months among infants with hypoxic-ischemic encephalopathy...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29058556/feasibility-of-a-miniature-esophageal-heat-exchange-device-for-rapid-therapeutic-cooling-in-newborns-preliminary-investigations-in-a-piglet-model
#20
John Dingley, Satomi Okano, Silvia Planas, Elavazhagan Chakkarapani
Therapeutic hypothermia (TH) after neonatal encephalopathy, commonly provided by 72 hours of whole-body cooling using a wrap, limits parents' physical contact with their infants affecting bonding and may not be suitable for encephalopathic preterm infants with fragile skin. Alternative cooling methods are unavailable for this population. We investigated in a neonatal pig model the feasibility of achieving a 3.5°C reduction in rectal temperature (Trectal) similar to clinical TH protocols from 38.5°C (normothermia for pigs) to a target of 35°C ± 0...
October 23, 2017: Therapeutic Hypothermia and Temperature Management
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