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neonatal therapeutic hypothermia

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https://www.readbyqxmd.com/read/28811085/the-use-of-phenobarbital-and-other-anti-seizure-drugs-in-newborns
#1
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...
August 12, 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
#2
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/28772198/cerebral-regional-oxygen-saturation-trends-in-infants-with-hypoxic-ischemic-encephalopathy
#3
Siddharth V Jain, Lindsay Pagano, Maria Gillam-Krakauer, James C Slaughter, Sumit Pruthi, Barbara Engelhardt
BACKGROUND: Neurological outcomes in neonatal hypoxic-ischemic encephalopathy (HIE) continue to be sub-optimal despite therapeutic hypothermia (TH). Cerebral near-infrared spectroscopy provides real-time regional oxygen saturation (CrSO2) that may be a marker of adverse MRI findings and neurodevelopmental outcomes. AIM: The aim of this study was to examine the value of CrSO2 monitoring in infants with HIE undergoing TH. STUDY DESIGN AND SUBJECTS: In this prospective study, CrSO2 was continuously recorded in 21 infants with HIE admitted for TH...
July 31, 2017: Early Human Development
https://www.readbyqxmd.com/read/28764944/-incidence-of-hypoxic-ischaemic-encephalopathy-and-use-of-therapeutic-hypothermia-in-spain
#4
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/28741035/biomarkers-of-hepatic-injury-and-function-in-neonatal-hypoxic-ischemic-encephalopathy-and-with-therapeutic-hypothermia
#5
Hemananda Muniraman, Danielle Gardner, Jane Skinner, Anna Paweletz, Anitha Vayalakkad, Ying Hui Chee, Clare Clifford, Sunil Sanka, Vidheya Venkatesh, Anna Curley, Suresh Victor, Mark A Turner, Paul Clarke
Therapeutic hypothermia (TH) is now provided as standard care to infants with moderate-severe hypoxic ischemic encephalopathy (HIE). The role of TH in limiting neuronal injury is well recognized, but its effect on hepatic injury which occurs frequently in neonatal HIE is not known. Our objective was to characterize biomarkers of liver injury and function in the setting of neonatal HIE and to describe whether HIE severity and provision of TH influence these hepatic biomarkers. We performed a multicenter retrospective study and compared hepatic biomarkers obtained during the first postnatal week, according to the severity of HIE and whether treated with TH...
July 24, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28695691/neonatal-therapeutic-hypothermia-outside-of-standard-guidelines-a-survey-of-u-s-neonatologists
#6
Jennifer Burnsed, Santina A Zanelli
AIM: Therapeutic hypothermia is standard of care in term infants with moderate-to-severe hypoxic-ischemic encephalopathy (HIE). The goal of this survey was to explore the attitudes of U.S. neonatologists caring for infants with HIE who fall outside of current guidelines. METHOD: Case-based survey administered to members of the Section on Neonatal-Perinatal Medicine of American Academy of Pediatrics. RESULTS: 447 responses were analyzed, i...
July 11, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28686927/servo-controlled-versus-manual-cooling-methods-in-neonates-with-hypoxic-ischemic-encephalopathy
#7
Ashok Buchiboyina, Eric Ma, Andrew Yip, Deepika Wagh, Jason Tan, Judy McMichael, Max Bulsara, Shripada Rao
BACKGROUND: Therapeutic hypothermia is known to improve outcomes in neonates with hypoxic ischemic encephalopathy (HIE). There are no studies that have compared servo controlled cooling (SCC) versus manually controlled cooling (MCC) methods in HIE. AIM: To compare the outcomes of SCC versus MCC in neonates with HIE. METHODS AND OUTCOME MEASURES: Between Jan 2008 and May 2011, MCC with cool-gel packs was used to achieve rectal temperatures of 33...
July 4, 2017: Early Human Development
https://www.readbyqxmd.com/read/28665923/non-invasive-continuous-cardiac-output-and-cerebral-perfusion-monitoring-in-term-infants-with-neonatal-encephalopathy-assessment-of-feasibility-and-reliability
#8
Eva Forman, Colm R Breatnach, Stephanie Ryan, Jana Semberova, Jan Miletin, Adrienne Foran, Afif El-Khuffash
BACKGROUND: None invasive hemodynamic monitoring of infants with neonatal encephalopathy (NE) undergoing therapeutic hypothermia (TH) would be a potentially useful clinical tool. We aimed assess the feasibility and reliability of non-invasive cardiac output monitoring (NICOM) and near infrared spectroscopy (NIRS) in this cohort. METHODS: NICOM and NIRS were commenced to measure cardiac output (CO), systemic vascular resistance (SVR), blood pressure (BP), and cerebral regional oxygen saturations (SctO2) during TH and rewarming...
June 30, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28665071/feasibility-and-safety-of-mild-therapeutic-hypothermia-in-poor-grade-subarachnoid-hemorrhage-prospective-pilot-study
#9
Wookjin Choi, Soon Chan Kwon, Won Joo Lee, Young Cheol Weon, Byungho Choi, Hyeji Lee, Eun Suk Park, Ryeok Ahn
Therapeutic hypothermia (TH) improves the neurological outcome in patients after cardiac arrest and neonatal hypoxic brain injury. We studied the safety and feasibility of mild TH in patients with poor-grade subarachnoid hemorrhage (SAH) after successful treatment. Patients were allocated randomly to either the TH group (34.5°C) or control group after successful clipping or coil embolization. Eleven patients received TH for 48 hours followed by 48 hours of slow rewarming. Vasospasm, delayed cerebral ischemia (DCI), functional outcome, mortality, and safety profiles were compared between groups...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28629243/effect-of-therapeutic-hypothermia-on-myocardial-dysfunction-in-term-neonates-with-perinatal-asphyxia-a-randomized-controlled-trial
#10
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/28628913/age-dependent-effects-of-alk5-inhibition-and-mechanism-of-neuroprotection-in-neonatal-hypoxic-ischemic-brain-injury
#11
Brian H Kim, Mariano Guardia Clausi, Michelle Frondelli, Israel C Nnah, Chaitali Saqcena, Radek Dobrowolski, Steven W Levison
Neonatal encephalopathy due to hypoxic-ischemic (HI) brain injury triggers a wave of neuroinflammatory events attributed to causing the progressive degeneration and functional deficits seen weeks after the initial insult. In a recent set of studies, we evaluated the therapeutic efficacy of a small molecule antagonist for ALK5 (activin-like kinase 5 ), TGF-β receptor in a rat model of moderate perinatal HI and found significant improvements in neurologic outcomes. Here, we have extended those studies to evaluate the efficacy of delayed TGF-β receptor antagonism on postnatal day (P) 6 and P9 HI rat pups with and without hypothermia...
2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28623417/a-validated-clinical-mri-injury-scoring-system-in-neonatal-hypoxic-ischemic-encephalopathy
#12
Shamik B Trivedi, Zachary A Vesoulis, Rakesh Rao, Steve M Liao, Joshua S Shimony, Robert C McKinstry, Amit M Mathur
BACKGROUND: Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. OBJECTIVES: To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MATERIALS AND METHODS: MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated...
June 16, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28619605/the-prognostic-value-of-proton-magnetic-resonance-spectroscopy-in-term-newborns-treated-with-therapeutic-hypothermia-following-asphyxia
#13
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/28573895/impacts-of-therapeutic-hypothermia-on-cardiovascular-hemodynamics-in-newborns-with-hypoxic-ischemic-encephalopathy-a-case-control-study-using-echocardiography
#14
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
#15
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/28561815/effects-of-therapeutic-hypothermia-on-white-matter-injury-from-murine-neonatal-hypoxia-ischemia
#16
Elliot Koo, R Ann Sheldon, Byong Sop Lee, Zinaida S Vexler, Donna M Ferriero
BackgroundTherapeutic hypothermia (TH) is the standard of care for neonates with hypoxic-ischemic encephalopathy, but it is not fully protective in the clinical setting. Hypoxia-ischemia (HI) may cause white matter injury (WMI), leading to neurological and cognitive dysfunction.MethodsP9 mice were subjected to HI as previously described. Pups underwent 3.5 h of systemic hypothermia or normothermia. Cresyl violet and Perl's iron staining for histopathological scoring of brain sections was completed blindly on all brains...
May 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28556862/therapeutic-hypothermia-to-treat-a-newborn-with-perinatal-hypoxic-ischemic-encephalopathy
#17
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/28549636/amplitude-integrated-electroencephalography-improves-the-identification-of-infants-with-encephalopathy-for-therapeutic-hypothermia-and-predicts-neurodevelopmental-outcomes-at-2-years-of-age
#18
Janne Helen Skranes, Gro Løhaugen, Eva Margrethe Schumacher, Damjan Osredkar, Andres Server, Frances Mary Cowan, Tom Stiris, Drude Fugelseth, Marianne Thoresen
OBJECTIVES: To examine whether using an amplitude-integrated electroencephalography (aEEG) severity pattern as an entry criterion for therapeutic hypothermia better selects infants with hypoxic-ischemic encephalopathy and to assess the time-to-normal trace for aEEG and magnetic resonance imaging (MRI) lesion load as 24-month outcome predictors. STUDY DESIGN: Forty-seven infants meeting Norwegian therapeutic hypothermia guidelines were enrolled prospectively. Eight-channel EEG/aEEG was recorded from 6 hours until after rewarming, and read after discharge...
August 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28504050/how-long-is-sufficient-for-optimal-neuroprotection-with-cerebral-cooling-after-ischemia-in-fetal-sheep
#19
Joanne O Davidson, Vittoria Draghi, Sean Whitham, Simerdeep K Dhillon, Guido Wassink, Laura Bennet, Alistair J Gunn
The optimal duration of mild "therapeutic" hypothermia for neonates with hypoxic-ischemic encephalopathy is surprisingly unclear. This study assessed the relative efficacy of cooling for 48 h versus 72 h. Fetal sheep (0.85 gestation) received sham ischemia (n = 9) or 30 min global cerebral ischemia followed by normothermia (n = 8) or delayed hypothermia from 3 h to 48 h (n = 8) or 72 h (n = 8). Ischemia was associated with profound loss of electroencephalogram (EEG) power, neurons in the cortex and hippocampus, and oligodendrocytes and myelin basic protein expression in the white matter, with increased Iba-1-positive microglia and proliferation...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28490023/cord-blood-il-16-is-associated-with-3-year-neurodevelopmental-outcomes-in-perinatal-asphyxia-and-hypoxic-ischaemic-encephalopathy
#20
Caroline E Ahearne, Ruby Y Chang, Brian H Walsh, Geraldine B Boylan, Deirdre M Murray
Activation of the inflammatory pathway is increasingly recognized as an important mechanism of injury following neonatal asphyxia and encephalopathy. This process may contribute to the poor prognosis seen in some cases, despite therapeutic hypothermia. Our group has previously identified raised interleukin (IL)-6 and IL-16, measured in umbilical cord blood at birth, to be predictive of grade of hypoxic-ischaemic encephalopathy (HIE). Our aim in this study was to examine the ability of these cytokines to predict the 3-year neurodevelopmental outcome in the same cohort...
2017: Developmental Neuroscience
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