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hypoxic ischemic encephalopathy cooling

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https://www.readbyqxmd.com/read/30092709/limited-benefit-of-slow-rewarming-after-cerebral-hypothermia-for-global-cerebral-ischemia-in-near-term-fetal-sheep
#1
Joanne O Davidson, Guido Wassink, Vittoria Draghi, Simerdeep K Dhillon, Laura Bennet, Alistair J Gunn
The optimal rate of rewarming after therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy is unknown, although it is widely suggested that slow rewarming is beneficial. Some preclinical studies suggest better outcomes with slower rewarming, but did not control for the duration of hypothermia. In this study, near-term fetal sheep (0.85 gestation) received 30 min cerebral ischemia followed by normothermia, 48 h hypothermia with rapid rewarming over 1 h, 48-h hypothermia with slow rewarming over 24 h, or 72-h hypothermia with rapid rewarming...
August 10, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/30046182/survey-of-ecmo-practices-for-infants-with-hypoxic-ischemic-encephalopathy
#2
Mark F Weems, Kirtikumar Upadhyay, Hitesh S Sandhu
OBJECTIVE: Historically, some physicians are reluctant to offer extracorporeal membrane oxygenation (ECMO) to infants with neonatal encephalopathy. This study describes how ECMO practices have changed since the development of therapeutic hypothermia (TH) for neonatal encephalopathy. STUDY DESIGN: A 22-question electronic survey was sent to neonatal medical directors and ECMO directors in the USA and Canada. Participants were queried on TH and ECMO practices and if they would offer ECMO given certain clinical factors; confidential responses were compared with a similar survey conducted in 2008...
July 25, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/30022316/passive-therapeutic-hypothermia-during-ambulance-and-helicopter-secondary-neonatal-transport-in-neonates-with-hypoxic-brain-injury-a-10-year-retrospective-survey
#3
Manca Leben, Manca Nolimal, Ivan Vidmar, Štefan Grosek
BACKGROUND: Therapeutic hypothermia is a method of treatment in newborns with hypoxic ischemic encephalopathy. Hypothermia should be initiated no later than 6 h after birth. The purpose of this study was to evaluate the quality of the passive therapeutic cooling during neonatal transport. PURPOSE: The study aims to evaluate the efficiency of our transport in maintenance of target body temperature during transport. METHODS: We conducted a 10-year retrospective study in neonates, transported by helicopter or ambulance, who received therapeutic passive-induced hypothermia during transport to the Department of Pediatric Surgery and Intensive Therapy at the University Medical Centre Ljubljana between September 1, 2006, and December 31, 2016...
July 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29968450/brain-cooling-reduces-the-risk-of-post-neonatal-epilepsy-in-newborns-affected-by-moderate-to-severe-hypoxic-ischemic-encephalopathy
#4
Licia Lugli, Eleonora Balestri, Alberto Berardi, Isotta Guidotti, Francesca Cavalleri, Alessandra Todeschini, Marisa Pugliese, Elisa Muttini Della Casa, Laura Lucaccioni, Fabrizio Ferrari
BACKGROUND: Neonatal hypoxic-ischemic encephalopathy is still a significant cause of neonatal death and neurodevelopmental disabilities, such as cerebral palsy, mental delay, and epilepsy. After the introduction of therapeutic hypothermia, the prognosis of hypoxic-ischemic encephalopathy has improved, with reduction of death and disabilities. However, few studies evaluated whether hypothermia affects rate and severity of post-neonatal epilepsy. We evaluated rates, characteristics and prognostic markers of post-neonatal epilepsy in infants with moderate to severe hypoxic-ischemic encephalopathy treated or not with therapeutic hypothermia...
July 2, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29866591/renal-saturation-and-acute-kidney-injury-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia
#5
Valerie Y Chock, Adam Frymoyer, Christine G Yeh, Krisa P Van Meurs
OBJECTIVE: To investigate the range of renal near-infrared spectroscopy (NIRS) measures in neonates undergoing therapeutic hypothermia for hypoxic ischemic encephalopathy (HIE) and to determine the association between renal NIRS measures and the development of acute kidney injury (AKI). STUDY DESIGN: A retrospective chart review was conducted of neonates with moderate to severe HIE who received therapeutic hypothermia at a tertiary care center from 2014 to 2016...
June 1, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29789056/the-six-hour-window-how-the-community-hospital-nursery-can-optimize-outcomes-of-the-infant-with-suspected-hypoxic-ischemic-encephalopathy
#6
Dafina Ibrani, Shanon Molacavage
Perinatal hypoxia is a devastating event before, during, or immediately after birth that deprives an infant's vital organs of oxygen. This injury at birth often requires a complex resuscitation and increases the newborn's risk of hypoxic-ischemic encephalopathy (HIE). The resuscitation team in a community hospital nursery may have less experience with complex resuscitation and post-resuscitation care of this infant than a NICU. This article provides the neonatal nurse in a Level I or Level II nursery with information about resuscitation and post-resuscitation care of an infant at risk of HIE while awaiting transport to a NICU for therapeutic cooling...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29710738/medico-legal-implications-of-hypothermic-neuroprotection-in-the-newborn
#7
S M Donn, J M Fanaroff
Hypoxic-ischemic encephalopathy (HIE) continues to be a significant source of long term neurological sequelae in infants born at or near term. In the past decade, selective head or whole body cooling has shown promising benefit in ameliorating some of the brain injury from intrapartum asphyxial insults and has become standard care in most developed countries. A decision to offer neuroprotective hypothermia (NPH) may engender subsequent litigation because it presupposes an acute intrapartum injury. Conversely, failing to offer cooling may be interpreted as a violation in the standard of care...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29622488/cerebral-autoregulation-and-conventional-and-diffusion-tensor-imaging-magnetic-resonance-imaging-in-neonatal-hypoxic-ischemic-encephalopathy
#8
Melisa Carrasco, Jamie Perin, Jacky M Jennings, Charlamaine Parkinson, Maureen M Gilmore, Raul Chavez-Valdez, An N Massaro, Raymond C Koehler, Frances J Northington, Aylin Tekes, Jennifer K Lee
BACKGROUND: Deviation of mean arterial blood pressure (MAP) from the range that optimizes cerebral autoregulatory vasoreactivity (optimal MAP) could increase neurological injury from hypoxic-ischemic encephalopathy (HIE). We tested whether a global magnetic resonance imaging (MRI) brain injury score and regional diffusion tensor imaging (DTI) are associated with optimal MAP in neonates with HIE. METHODS: Twenty-five neonates cooled for HIE were monitored with the hemoglobin volume index...
May 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29562785/extracellular-vesicles-derived-from-wharton-s-jelly-mesenchymal-stem-cells-prevent-and-resolve-programmed-cell-death-mediated-by-perinatal-hypoxia-ischemia-in-neuronal-cells
#9
Marianne S Joerger-Messerli, Byron Oppliger, Marialuigia Spinelli, Gierin Thomi, Ivana di Salvo, Philipp Schneider, Andreina Schoeberlein
Hypoxic-ischemic (HI) insult in the perinatal phase harbors a high risk of encephalopathy in the neonate. Brain cells undergo apoptosis, initiating neurodegeneration. So far, therapeutic approaches such as cooling remain limited. Transplantation of mesenchymal stem cells (MSCs) exhibits therapeutic success despite the short-time survival in the host brain, providing strong evidence that their beneficial effects are largely based on secreted factors, including extracellular vesicles (EVs). The aim of this study was to investigate the effects of human Wharton's jelly MSC (hWJ-MSC)-derived EVs on neuroprotection and neuroregeneration, using an in vitro model of oxygen-glucose deprivation/reoxygenation (OGD/R) mimicking HI injury in the mouse neuroblastoma cell line neuro2a (N2a)...
January 2018: Cell Transplantation
https://www.readbyqxmd.com/read/29502880/pulmonary-hypertension-associated-with-hypoxic-ischemic-encephalopathy-antecedent-characteristics-and-comorbidities
#10
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
#11
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/29475200/cardiovascular-associations-with-abnormal-brain-magnetic-resonance-imaging-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia-and-rewarming
#12
Kiran S More, Pankaj Sakhuja, Regan E Giesinger, Joseph Y Ting, Matthew Keyzers, Jesal N Sheth, Anie Lapointe, Amish Jain, Aideen M Moore, Steven P Miller, Patrick J McNamara
OBJECTIVE:  This article compares hemodynamic characteristics of neonates with hypoxic ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) with normal versus abnormal brain magnetic resonance imaging (MRI). METHODS:  Serial echocardiography (echo) was performed within 24 hours, after 48 to 72 hours of cooling, within 24 hours of normothermia, and after starting feeds. Pulmonary hemodynamics, cardiac output, and ventricular function were evaluated...
February 23, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29471782/transcapillary-fluid-flux-and-inflammatory-response-during-neonatal-therapeutic-hypothermia-an-open-longitudinal-observational-study
#13
Hans Jørgen Timm Guthe, Torbjørn Nedrebø, Jan Kristian Damås, Helge Wiig, Ansgar Berg
BACKGROUND: Therapeutic hypothermia is neuroprotective in asphyxiated neonates by counteracting mechanisms contributing to brain injury. Although an initial increased permeability is part of an inflammatory reaction and thereby a natural healing process, an excessive endothelial permeability with edema formation may result in impaired hemodynamics. Reduced permeability may, however, benefit healing. Although plasma and interstitial colloid osmotic pressure are accessible and essential parameters for understanding fluid imbalance, the mechanisms of fluid exchange remain poorly understood...
February 23, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29460554/cirp-expression-and-therapeutic-hypothermia-for-neonatal-hypoxic-ischemic-encephalopathy-hie-a-factor-to-consider-when-selecting-depth-and-duration-of-cooling
#14
https://www.readbyqxmd.com/read/29375880/absolute-lymphocyte-and-neutrophil-counts-in-neonatal-ischemic-brain-injury
#15
Jessica M Povroznik, Elizabeth B Engler-Chiurazzi, Tania Nanavati, Paola Pergami
Objectives: This study aimed to identify differences in absolute neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio between neonates with two forms of ischemic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke, compared to controls. We also aimed to determine whether this neutrophil/lymphocyte response pattern is associated with disease severity or is a consequence of the effects of total-body cooling, an approved treatment for moderate-to-severe hypoxic-ischemic encephalopathy...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29341043/can-neonatal-brain-mri-be-performed-during-active-cooling
#16
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...
July 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29242417/phase-changing-material-for-therapeutic-hypothermia-in-neonates-with-hypoxic-ischemic-encephalopathy-a-multi-centric-study
#17
MULTICENTER STUDY
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...
March 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29165765/hypothermia-in-neonatal-hypoxic-ischemic-encephalopathy-hie
#18
REVIEW
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/29048405/cooling-in-neonatal-hypoxic-ischemic-encephalopathy-practices-and-opinions-on-minimum-standards-in-the-state-of-california
#19
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...
January 2018: 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
#20
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...
December 2017: Neurocritical Care
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