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Hypoxic ischaemic encephalopathy

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https://www.readbyqxmd.com/read/28443558/towards-evidence-based-resuscitation-of-the-newborn-infant
#1
REVIEW
Brett J Manley, Louise S Owen, Stuart B Hooper, Susan E Jacobs, Jeanie L Y Cheong, Lex W Doyle, Peter G Davis
Effective resuscitation of the newborn infant has the potential to save many lives around the world and reduce disabilities in children who survive peripartum asphyxia. In this Series paper, we highlight some of the important advances in the understanding of how best to resuscitate newborn infants, which includes monitoring techniques to guide resuscitative efforts, increasing awareness of the adverse effects of hyperoxia, delayed umbilical cord clamping, the avoidance of routine endotracheal intubation for extremely preterm infants, and therapeutic hypothermia for hypoxic-ischaemic encephalopathy...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28434009/hypoxic-ischaemic-encephalopathy-and-the-blood-brain-barrier-in-neonates
#2
Wei Ling Amelia Lee, Adina T Michael-Titus, Divyen K Shah
This review aims to highlight a possible relationship between hypoxic-ischaemic encephalopathy (HIE) and the disruption of the blood-brain barrier (BBB). Inflammatory reactions perpetuate a large proportion of cerebral injury. The extent of injury noted in HIE is not only determined by the biochemical cascades that trigger the apoptosis-necrosis continuum of cell death in the brain parenchyma, but also by the breaching of the BBB by pro-inflammatory factors. We examine the changes that contribute to the breakdown of the BBB that occur during HIE at a macroscopic, cellular, and molecular level...
April 22, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28433953/the-ability-of-early-serial-developmental-assessment-to-predict-outcome-at-5years-following-neonatal-hypoxic-ischaemic-encephalopathy
#3
Catherine M O'Connor, C Anthony Ryan, Geraldine B Boylan, Deirdre M Murray
BACKGROUND: Neurodevelopmental difficulties in children following hypoxic-ischaemic encephalopathy (HIE) may not emerge until school age. AIMS: To evaluate the value and stability of early serial developmental assessments in predicting long-term outcome. STUDY DESIGN: Prospective study of infants with neonatal HIE and early continuous EEG at birth. SUBJECTS: Term infants with HIE were recruited at birth. Development was measured at 6, 12 and 24months using the Revised Griffiths' Scales (GMDS-R)...
April 20, 2017: Early Human Development
https://www.readbyqxmd.com/read/28409211/risks-of-asphyxia-related-neonatal-complications-in-offspring-of-mothers-with-type-1-or-type-2-diabetes-the-impact-of-maternal-overweight-and-obesity
#4
Sven Cnattingius, Anna Lindam, Martina Persson
AIMS/HYPOTHESIS: We aimed to compare the risks of severe asphyxia-related neonatal complications in the offspring of mothers with type 1 or type 2 diabetes, and to assess the impact of maternal overweight/obesity on these risks. METHODS: This was a population-based study of 1,343,751 live-born singleton infants in Sweden between 1997 and 2011, including 5941 and 711 infants of mothers with type 1 and type 2 diabetes, respectively. ORs with 95% CIs were calculated for low Apgar score (0-6) at 5 min after birth, hypoxic ischaemic encephalopathy and neonatal seizures...
April 13, 2017: Diabetologia
https://www.readbyqxmd.com/read/28392102/creatine-phosphate-administration-in-cell-energy-impairment-conditions-a-summary-of-past-and-present-research
#5
REVIEW
A V Gaddi, P Galuppo, J Yang
BACKGROUND: Creatine phosphate (CrP) plays a fundamental physiological role by providing chemical energy for cell viability and activity, especially in muscle tissue. Numerous pathological conditions, caused by acute or chronic ischaemic situations, are related to its deficiency. For these reasons, it has been used as a cardioprotective agent in heart surgery and medical cardiology for many years. OBJECTIVE: This article gives a brief overview of the main characteristics of exogenous CrP...
March 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#6
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
April 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28351039/prognostic-value-of-the-apparent-diffusion-coefficient-in-newborns-with-hypoxic-ischaemic-encephalopathy-treated-with-therapeutic-hypothermia
#7
Eva-Marie Heursen, Amaya Zuazo Ojeda, Isabel Benavente Fernández, Gema Jimenez Gómez, Rosalía Campuzano Fernández-Colima, José Paz-Expósito, Simón Pedro Lubián López
BACKGROUND: Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia. OBJECTIVES: To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH). METHODS: This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH...
March 29, 2017: Neonatology
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#8
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28278217/passive-hypothermia-%C3%A2-35-36%C3%A2-c-during-transport-of-newborns-with-hypoxic-ischaemic-encephalopathy
#9
Aurélie Sellam, Noëlla Lode, Azzedine Ayachi, Gilles Jourdain, Stéphane Dauger, Peter Jones
BACKGROUND: Hypothermia initiated in the first six hours of life in term infants with hypoxic ischemic encephalopathy reduces the risk of death and severe neurological sequelae. Our study's principal objective was to evaluate transport predictors potentially influencing arrival in NICU (Neonatal Intensive Care Unit) at a temperature ≥35-<36°C. METHODOLOGY/PRINCIPAL FINDINGS: A multi-centric, prospective cohort study was conducted during 18 months by the three Neonatal Transport Teams and 13 NICUs...
2017: PloS One
https://www.readbyqxmd.com/read/28273115/therapeutic-hypothermia-increases-the-risk-of-cardiac-arrhythmia-for-perinatal-hypoxic-ischaemic-encephalopathy-a-meta-analysis
#10
Wei Zhang, Meizhu Lu, Chenlong Zhang, Ruwen Zhang, Xiaofeng Ou, Jianju Zhou, Yan Li, Yan Kang
OBJECTIVE: To determine whether therapeutic hypothermia after hypoxic ischaemic encephalopathy (HIE) in neonates increases the risk of cardiac arrhythmia during intervention. DESIGN: A meta-analysis was conducted using a fixed-effect model. Risk ratios, risk differences, and 95% confidence intervals, were measured. DATA SOURCES: Studies identified from the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Google Scholar, previous reviews, and abstracts from onset to August, 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28258592/neonatal-somatosensory-evoked-potentials-persist-during-hypothermia
#11
Päivi Nevalainen, Leena Lauronen, Marjo Metsäranta, Tuula Lönnqvist, Eero Ahtola, Sampsa Vanhatalo
AIM: Treatment with therapeutic hypothermia has challenged the use of amplitude-integrated electroencephalography in predicting outcomes after perinatal asphyxia. In this study, we assessed the feasibility and gain of somatosensory evoked potentials (SEP) during hypothermia. METHODS: This retrospective study comprised neonates from 35 + 6 to 42 + 2 gestational weeks and treated for asphyxia or hypoxic-ischaemic encephalopathy at Helsinki University Hospital between 14 February 2007 and 23 December 2009...
March 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28183808/observational-study-of-haemostatic-dysfunction-and-bleeding-in-neonates-with-hypoxic-ischaemic-encephalopathy
#12
Mitali A Pakvasa, Anne M Winkler, Shannon E Hamrick, Cassandra D Josephson, Ravi M Patel
OBJECTIVE: Evaluate the relationship between initial haemostatic parameters and the frequency and severity of bleeding in neonates with hypoxic-ischaemic encephalopathy (HIE). DESIGN: Retrospective observational cohort study. SETTING: 2 academically affiliated level III neonatal intensive care units in Atlanta, Georgia. PARTICIPANTS: 98 neonates with moderate-to-severe HIE who underwent haemostatic testing within 12 hours of birth and were born from 1 January 2008 to 31 December 2013...
February 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28159528/therapeutic-hypothermia-may-improve-neurological-outcomes-in-extracorporeal-life-support-for-adult-cardiac-arrest
#13
Philip Y K Pang, Gillian H L Wee, Ming Jie Huang, Anne E E Hoo, Ismail Mohamed Tahir Sheriff, See Lim Lim, Teing Ee Tan, Yee Jim Loh, Victor T T Chao, Jia Lin Soon, Ka Lee Kerk, Zakir Hussain Abdul Salam, Yoong Kong Sin, Chong Hee Lim
BACKGROUND: Limited data exists on patients receiving therapeutic hypothermia during extracorporeal life support (ECLS). We investigated outcomes and prognostic factors in these patients. METHODS: A retrospective review was conducted for 225 consecutive adult patients treated with ECLS between July 2003 and January 2016. Extracorporeal life support was initiated for refractory cardiac arrest (>10 mins) in 79 patients (35.1%). Patient demographics, ECLS-related complications, in-hospital mortality and neurological outcomes were analysed...
January 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28125772/cardiotocography-versus-intermittent-auscultation-of-fetal-heart-on-admission-to-labour-ward-for-assessment-of-fetal-wellbeing
#14
REVIEW
Declan Devane, Joan G Lalor, Sean Daly, William McGuire, Anna Cuthbert, Valerie Smith
BACKGROUND: The admission cardiotocograph (CTG) is a commonly used screening test consisting of a short (usually 20 minutes) recording of the fetal heart rate (FHR) and uterine activity performed on the mother's admission to the labour ward. This is an update of a review published in 2012. OBJECTIVES: To compare the effects of admission cardiotocography with intermittent auscultation of the FHR on maternal and infant outcomes for pregnant women without risk factors on their admission to the labour ward...
January 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28105895/prefrontal-cortex-dysfunction-in-hypoxic-ischaemic-encephalopathy-contributes-to-executive-function-impairments-in-rats-potential-contribution-for-attention-deficit-hyperactivity-disorder
#15
Patrícia Maidana Miguel, Bruna Ferrary Deniz, Iohanna Deckmann, Heloísa Deola Confortim, Ramiro Diaz, Daniela Pereira Laureano, Patrícia Pelufo Silveira, Lenir Orlandi Pereira
OBJECTIVES: The attention-deficit/hyperactivity disorder (ADHD) compromises the quality of life of individuals including adaptation to the social environment. ADHD aetiology includes perinatal conditions such as hypoxic-ischaemic events; preclinical studies have demonstrated attentional deficits and impulsive-hyperactive outcomes after neonatal hypoxic and/or ischaemic intervention, but data are missing to understand this relationship. Thus, the aim of this study was to evaluate executive function (EF) and impulsivity, and tissue integrity and dopaminergic function in the prefrontal cortex (PFC) of rats submitted to hypoxia-ischaemia (HI)...
January 20, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28097694/serial-cytokine-alterations-and-abnormal-neuroimaging-in-newborn-infants-with-encephalopathy
#16
Fiona M O'Hare, R William G Watson, Amanda O'Neill, Ricardo Segurado, Deirdre Sweetman, Paul Downey, Eoghan Mooney, John Murphy, Veronica Donoghue, Eleanor J Molloy
AIM: Inflammatory cytokines may play a role in the final common pathway in the pathogenesis of hypoxic-ischaemic injury in experimental models. We aimed to profile the systemic pro-and anti-inflammatory response over the first week of life in term infants at risk of neonatal encephalopathy. METHOD: In a tertiary referral university neonatal intensive care unit, serial blood samples were analysed from 41 term infants (requiring resuscitation at birth) in this prospective observational pilot study...
January 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/27957679/downstream-mrna-target-analysis-in-neonatal-hypoxic-ischaemic-encephalopathy-identifies-novel-marker-of-severe-injury-a-proof-of-concept-paper
#17
A M Looney, C E Ahearne, B Hallberg, G B Boylan, D M Murray
Human microRNA miR-374a is downregulated in the umbilical cord blood (UCB) of infants with hypoxic-ischaemic encephalopathy (HIE). The downstream targets of this microRNA (miRNA) are unclear, but one putative target is the activin-A receptor type IIb (ACVR2B). ACVR2B is required for activin-A function and previous reports have shown alterations of activin-A levels in neonatal HIE. Our aim was to investigate the expression of the potential downstream targets of miR-374a, activin-A and ACVR2B, at birth in a cohort of full-term infants with perinatal asphyxia (PA) only, and those with PA who developed clinical and electrographic HIE...
December 12, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27902983/perinatal-asphyxia-and-erythropoietin-and-vegf-serial-serum-and-cerebrospinal-fluid-responses
#18
Deirdre U Sweetman, Chike Onwuneme, William R Watson, John F A Murphy, Eleanor J Molloy
BACKGROUND: Infants with neonatal encephalopathy (NE) of hypoxic-ischaemic origin are at risk of oxidative and ischaemia-reperfusion injury, which may induce abnormal inflammatory responses involving excessive cytokine production and release in serum and cerebrospinal fluid (CSF). Systemic inflammation is found in infants with NE, and we therefore were interested in cytokines associated with hypoxia, including vascular endothelial growth factor (VEGF) and erythropoietin (Epo). OBJECTIVE: To investigate the relationship between Epo, VEGF levels, brain injury and outcome in a group of term infants exposed to perinatal asphyxia (PA) compared to controls...
2017: Neonatology
https://www.readbyqxmd.com/read/27885286/immediate-outcome-of-hypoxic-ischaemic-encephalopathy-in-hypoxiate-newborns-in-nepal-medical-college
#19
S Shrestha, G S Shrestha, A Sharma
BACKGROUND: Birth asphyxia is the fifth major cause of under-five child deaths after pneumonia, diarrhoea, neonatal infections and complications of preterm birth. It is one of the important causes of neonatal mortality and morbidity accounting up to 30% of neonatal death in Nepal. It is also an important cause of long-term neurological disability and impairment. The mortality rate due to birth asphyxia is considered a good guide to the quality of perinatal care. This study was conducted to assess the rate of birth asphyxia, risk factors and outcome of the babies who were asphyxiated at birth...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27824913/treatment-trials-for-neonatal-seizures-the-effect-of-design-on-sample-size
#20
Nathan J Stevenson, Geraldine B Boylan, Lena Hellström-Westas, Sampsa Vanhatalo
Neonatal seizures are common in the neonatal intensive care unit. Clinicians treat these seizures with several anti-epileptic drugs (AEDs) to reduce seizures in a neonate. Current AEDs exhibit sub-optimal efficacy and several randomized control trials (RCT) of novel AEDs are planned. The aim of this study was to measure the influence of trial design on the required sample size of a RCT. We used seizure time courses from 41 term neonates with hypoxic ischaemic encephalopathy to build seizure treatment trial simulations...
2016: PloS One
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