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hypoxic ischemic encephalopathy cooling

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https://www.readbyqxmd.com/read/30279083/electroencephalography-and-brain-magnetic-resonance-imaging-in-asphyxia-comparing-cooled-and-non-cooled-infants
#1
Leen Att De Wispelaere, Sabine Ouwehand, Marielle Olsthoorn, Paul Govaert, Liesbeth S Smit, Rogier Cj de Jonge, Maarten H Lequin, Irwin K Reiss, Jeroen Dudink
OBJECTIVE: The aim was to establish any differences in the predictive value of EEG and MRI for outcome in infants treated and not-treated with therapeutic hypothermia (HT) for perinatal asphyxia. We hypothesize that they are equally predictive and that combining both has the highest predictive value. STUDY DESIGN: We retrospectively compared data of infants with hypoxic-ischemic encephalopathy (HIE) who received HT (n = 45) between September 2009 and December 2013 with those of infants with HIE born between January 2004 and August 2009, before HT was available (NT, n = 37)...
September 12, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/30250303/prospective-research-in-infants-with-mild-encephalopathy-identified-in-the-first-six-hours-of-life-neurodevelopmental-outcomes-at-18-22-months
#2
Lina F Chalak, Kim-Anh Nguyen, Chatchay Prempunpong, Roy Heyne, Sudhin Thayyil, Seetha Shankaran, Abbot R Laptook, Nancy Rollins, Athina Pappas, Louise Koclas, Birju Shah, Paolo Montaldo, Benyachalee Techasaensiri, Pablo J Sánchez, Guilherme Sant'Anna
BACKGROUND: Studies of early childhood outcomes of mild hypoxic-ischemic encephalopathy (HIE) identified in the first 6 h of life are lacking. OBJECTIVE: To evaluate neurodevelopmental outcomes at 18-22 months of PRIME study. STUDY DESIGN: Multicenter, prospective study of mild HIE defined as ≥1 abnormality using the modified Sarnat within 6 h of birth and not meeting cooling criteria. Primary outcome was disability with mild: Bayley III cognitive 70-84 or ≥85 and either Gross Motor Function Classification System (GMFCS) 1 or 2, seizures, or hearing deficit; moderate: cognitive 70-84 and either GMFCS 2, seizures, or hearing deficit; severe: cognitive <70, GMFCS 3-5...
September 13, 2018: Pediatric Research
https://www.readbyqxmd.com/read/30219051/prognostic-value-of-early-conventional-proton-magnetic-resonance-spectroscopy-in-cooled-asphyxiated-infants
#3
Hajnalka Barta, Agnes Jermendy, Marton Kolossvary, Lajos R Kozak, Andrea Lakatos, Unoke Meder, Miklos Szabo, Gabor Rudas
BACKGROUND: Neonatal hypoxic-ischemic encephalopathy (HIE) commonly leads to neurodevelopmental impairment, raising the need for prognostic tools which may guide future therapies in time. Prognostic value of proton MR spectroscopy (H-MRS) between 1 and 46 days of age has been extensively studied; however, the reproducibility and generalizability of these methods are controversial in a general clinical setting. Therefore, we investigated the prognostic performance of conventional H-MRS during first 96 postnatal hours in hypothermia-treated asphyxiated neonates...
September 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/30149475/transplacental-lidocaine-intoxication
#4
V Demeulemeester, H V Hauthem, F Cools, J Lefevere
Neonatal seizures are frequent in neonatal intensive care and the most common cause is perinatal asphyxia. Among other causes, toxin exposure is rare.We present a boy with an uneventful vaginal birth, who presented one hour after birth with apnea, hypotonia, mydriasis, tongue fasciculation, and tonic seizures. There was no hypoxic ischemic encephalopathy and brain imaging was normal. Toxicology screening revealed a toxic concentration of lidocaine in his blood. The intoxication was transplacental, as a cord blood sample confirmed the toxic level...
August 21, 2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/30092709/limited-benefit-of-slow-rewarming-after-cerebral-hypothermia-for-global-cerebral-ischemia-in-near-term-fetal-sheep
#5
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
#6
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...
September 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
#7
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
#8
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
#9
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...
September 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
August 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
#17
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
#18
https://www.readbyqxmd.com/read/29375880/absolute-lymphocyte-and-neutrophil-counts-in-neonatal-ischemic-brain-injury
#19
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
#20
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
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