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neonatal therapeutic hypothermia

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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
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/29053702/the-effects-of-adding-prophylactic-phenobarbital-to-therapeutic-hypothermia-in-the-term-equivalent-hypoxic-ischemic-rat
#6
Sushma Krishna, Alexandra Hutton, Eric Aronowitz, Holly Moore, Susan J Vannucci
BackgroundHypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal morbidity and mortality. Therapeutic hypothermia (TH) is the only available intervention, but neuroprotection is incomplete and variable. Seizures are common in infants with HIE undergoing TH and may worsen outcome. Phenobarbital is sometimes added, although use of prophylactic phenobarbital is controversial in the neonate. We hypothesize that prophylactic phenobarbital (PB) will not reduce, and may enhance, the neuroprotective effects of TH on brain injury and motor outcomes in the postnatal-day 10 (P10) hypoxic-ischemic (HI) rat...
October 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29048405/cooling-in-neonatal-hypoxic-ischemic-encephalopathy-practices-and-opinions-on-minimum-standards-in-the-state-of-california
#7
C J Wusthoff, C L Clark, H C Glass, T K Shimotake, J Schulman, S L Bonifacio
OBJECTIVE: Although hospitals increasingly offer therapeutic hypothermia (TH), there is variable implementation of related services. We assessed current practices and opinions regarding what services should be required of centers providing TH in California. STUDY DESIGN: We surveyed neonatal intensive care unit physicians statewide regarding practices and opinions about services related to TH. RESULTS: Of the 50 participating centers (47% response rate), 66% offer TH...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#8
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29025962/therapeutic-hypothermia-in-acute-traumatic-spinal-cord-injury
#9
James Collis
Therapeutic hypothermia is already widely acknowledged as an effective neuroprotective intervention, especially within the acute care setting in relation to conditions such as cardiac arrest and neonatal encephalopathy. Its multifactorial mechanisms of action, including lowering metabolic rate and reducing acute inflammatory cellular processes, ultimately provide protection for central nervous tissue from continuing injury following ischaemic or traumatic insult. Its clinical application within acute traumatic spinal cord injury would therefore seem very plausible, it having the potential to combat the pathophysiological secondary injury processes that can develop in the proceeding hours to days following the initial injury...
October 12, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29016557/future-perspectives-of-cell-therapy-for-neonatal-hypoxic-ischemic-encephalopathy
#10
REVIEW
Makoto Nabetani, Haruo Shintaku, Takashi Hamazaki
Neonatal ischemic brain injury causes permanent motor-deficit cerebral palsy. Hypoxic-ischemic encephalopathy (HIE) is a very serious condition that can result in death and disability. In 1997, we reported that irreversible neuronal cell damage is induced by the elevation of intracellular Ca ion concentration that has occurred in sequence after excess accumulation of the excitatory neurotransmitter glutamate during ischemia. We also reported that hypothermia was effective in treating ischemic brain damage in rats by suppressing energy loss and raising intracellular Ca ion concentration...
October 10, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28993332/amikacin-pharmacokinetics-to-optimize-dosing-in-neonates-with-perinatal-asphyxia-treated-with-hypothermia
#11
Sinziana Cristea, Anne Smits, Aida Kulo, Catherijne A J Knibbe, Mirjam van Weissenbruch, Elke H J Krekels, Karel Allegaert
Aminoglycosides pharmacokinetics (PK) is expected to change in neonates with perinatal asphyxia treated with therapeutic hypothermia (PATH). Several amikacin dosing guidelines have been proposed to treat neonates with (suspected) septicemia, however, none provide adjustments in the case of PATH. Therefore, we aimed to quantify the differences in amikacin PK between neonates with and without PATH to propose suitable dosing recommendations.Based on amikacin therapeutic drug monitoring data collected retrospectively from neonates with PATH, combined with a published dataset, we assessed the impact of PATH on amikacin PK using population modelling...
October 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28980775/long-term-recovery-after-endothelial-colony-forming-cells-or-human-umbilical-cord-blood-cells-administration-in-a-rat-model-of-neonatal-hypoxic-ischemic-encephalopathy
#12
Isabelle Grandvuillemin, Philippe Garrigue, Alaa Ramdani, Farid Boubred, Umberto Simeoni, Françoise Dignat-George, Florence Sabatier, Benjamin Guillet
Neonatal hypoxic-ischemic encephalopathy (NHIE) is a dramatic perinatal complication, associated with poor neurological prognosis despite neuroprotection by therapeutic hypothermia, in the absence of an available curative therapy. We evaluated and compared ready-to-use human umbilical cord blood cells (HUCBC) and bankable but allogeneic endothelial progenitors (ECFC) as cell therapy candidate for NHIE. We compared benefits of HUCBC and ECFC transplantation 48 hours after injury in male rat NHIE model, based on the Rice-Vannucci approach...
November 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28958093/evolution-of-amplitude-integrated-electroencephalogram-as-a-predictor-of-outcome-in-term-encephalopathic-neonates-receiving-therapeutic-hypothermia
#13
Elizabeth K Sewell, Gilbert Vezina, Taeun Chang, Tammy Tsuchida, Kari Harris, Michelande Ridore, Penny Glass, An N Massaro
No abstract text is available yet for this article.
September 28, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28946160/bleeding-complications-and-mortality-in-neonates-receiving-therapeutic-hypothermia-and-extracorporeal-membrane-oxygenation
#14
Milenka Cuevas Guaman, Ashley M Lucke, Joseph L Hagan, Jeffrey R Kaiser
No abstract text is available yet for this article.
September 25, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28942435/re-examining-the-arterial-cord-blood-gas-ph-screening-criteria-in-neonatal-encephalopathy
#15
Zachary Andrew Vesoulis, Steve M Liao, Rakesh Rao, Shamik B Trivedi, Alison G Cahill, Amit M Mathur
OBJECTIVE: Screening criteria for neonatal encephalopathy remain a complex combination of subjective and objective criteria. We examine the utility of universal cord blood gas testing and mandatory encephalopathy evaluation for infants with pH ≤7.10 on umbilical cord arterial blood gas (cABG) as a single screening measure for timely identification of moderate/severe encephalopathy. DESIGN, SETTING, PATIENTS: Infants born at a single centre between 2008 and 2015, who were ≥36 weeks, had no congenital anomalies and had a cABG pH ≤7...
September 23, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28942433/therapeutic-hypothermia-in-mild-neonatal-encephalopathy-a-national-survey-of-practice-in-the-uk
#16
Vânia Oliveira, Dev Prya Singhvi, Paolo Montaldo, Peter J Lally, Josephine Mendoza, Swati Manerkar, Seetha Shankaran, Sudhin Thayyil
Although major cooling trials (and subsequent guidelines) excluded babies with mild encephalopathy, anecdotal evidence suggests that cooling is often offered to these infants. We report a national survey on current cooling practices for babies with mild encephalopathy in the UK. From 74 neonatal units contacted, 68 were cooling centres. We received 54 responses (79%) and included 48 (five excluded due to incomplete data and one found later not to offer cooling). Of these, 36 centres (75%) offered cooling to infants with mild encephalopathy...
September 23, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28939695/oxidative-stress-and-endoplasmic-reticulum-er-stress-in-the-development-of-neonatal-hypoxic-ischaemic-brain-injury
#17
REVIEW
Claire Thornton, Ana A Baburamani, Anton Kichev, Henrik Hagberg
Birth asphyxia in term neonates affects 1-2/1000 live births and results in the development of hypoxic-ischaemic encephalopathy with devastating life-long consequences. The majority of neuronal cell death occurs with a delay, providing the potential of a treatment window within which to act. Currently, treatment options are limited to therapeutic hypothermia which is not universally successful. To identify new interventions, we need to understand the molecular mechanisms underlying the injury. Here, we provide an overview of the contribution of both oxidative stress and endoplasmic reticulum stress in the development of neonatal brain injury and identify current preclinical therapeutic strategies...
October 15, 2017: Biochemical Society Transactions
https://www.readbyqxmd.com/read/28938291/feasibility-and-safety-of-controlled-active-hypothermia-treatment-during-transport-in-neonates-with-hypoxic-ischemic-encephalopathy
#18
Eniko Szakmar, Kata Kovacs, Unoke Meder, Agnes Nagy, Andras Szell, Bojan Bundzsity, Zsolt Somogyvari, Attila J Szabo, Miklos Szabo, Agnes Jermendy
OBJECTIVES: To evaluate the feasibility and safety of controlled active hypothermia versus standard intensive care during neonatal transport in patients with hypoxic-ischemic encephalopathy. DESIGN: Cohort study with a historic control group. SETTING: All infants were transported by Neonatal Emergency & Transport Services to a Level-III neonatal ICU. PATIENTS: Two hundred fourteen term newborns with moderate-to-severe hypoxic-ischemic encephalopathy...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28931055/serum-copeptin-and-neuron-specific-enolase-are-markers-of-neonatal-distress-and-long-term-neurodevelopmental-outcome
#19
RANDOMIZED CONTROLLED TRIAL
Dorottya Kelen, Csilla Andorka, Miklós Szabó, Aleksander Alafuzoff, Kai Kaila, Milla Summanen
The objective of this study was to evaluate the early changes in serial serum levels of copeptin and neuron-specific enolase (NSE) in neonates diagnosed with birth asphyxia, and to determine whether these biomarkers measured in the first 168 hours after birth are predictive of long-term neurodevelopmental outcome. Copeptin and NSE levels were measured from serum samples collected 6, 12, 24, 48, 72, and 168 hours after birth from 75 term neonates diagnosed with hypoxic-ischemic encephalopathy (HIE) and treated with therapeutic hypothermia for 72 hours...
2017: PloS One
https://www.readbyqxmd.com/read/28931035/neuroprotection-with-hypothermia-and-allopurinol-in-an-animal-model-of-hypoxic-ischemic-injury-is-it-a-gender-question
#20
COMPARATIVE STUDY
Javier Rodríguez-Fanjul, Cristina Durán Fernández-Feijóo, Míriam Lopez-Abad, Maria Goretti Lopez Ramos, Rafael Balada Caballé, Soledad Alcántara-Horillo, Marta Camprubí Camprubí
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is one of the most important causes of neonatal brain injury. Therapeutic hypothermia (TH) is the standard treatment for term newborns after perinatal hypoxic ischemic injury (HI). Despite this, TH does not provide complete neuroprotection. Allopurinol seems to be a good neuroprotector in several animal studies, but it has never been tested in combination with hypothermia. Clinical findings show that male infants with (HI) fare more poorly than matched females in cognitive outcomes...
2017: PloS One
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