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Hypoxic-ischemic encephalopathy

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https://www.readbyqxmd.com/read/28426467/neuron-specific-enolase-predicts-poor-outcome-after-cardiac-arrest-and-targeted-temperature-management-a-multicenter-study-on-1-053-patients
#1
Kaspar Josche Streitberger, Christoph Leithner, Michael Wattenberg, Peter H Tonner, Julia Hasslacher, Michael Joannidis, Tommaso Pellis, Elena Di Luca, Markus Födisch, Alexander Krannich, Christoph J Ploner, Christian Storm
OBJECTIVE: Outcome prediction after cardiac arrest is important to decide on continuation or withdrawal of intensive care. Neuron-specific enolase is an easily available, observer-independent prognostic biomarker. Recent studies have yielded conflicting results on its prognostic value after targeted temperature management. DESIGN, SETTING, AND PATIENTS: We analyzed neuron-specific enolase serum concentrations 3 days after nontraumatic in-hospital cardiac arrest and out-of-hospital cardiac arrest and outcome of patients from five hospitals in Germany, Austria, and Italy...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28418828/a-comparison-of-blood-and-cerebrospinal-fluid-cytokines-il-1%C3%AE-il-6-il-18-tnf-%C3%AE-in-neonates-with-perinatal-hypoxia
#2
Darinka Šumanović-Glamuzina, Filip Čulo, Melanie Ivana Čulo, Paško Konjevoda, Marjana Jerković-Raguž
Perinatal hypoxia-ischemia is a specific and important pathological event in neonatal care practice. The data on relationship between the concentrations of cytokines in blood and cerebrospinal fluid (CSF) and perinatal brain injury are scarce. The aim of this study is to evaluate changes in interleukin (IL-1β, IL-6, and IL-18) and tumor necrosis factor alpha (TNF-α) levels in newborns with perinatal hypoxia (PNH). CSF and serum samples of 35 term and near-term (35-40 weeks) newborns with PNH, at the age of 3-96 hours, were analyzed using enzyme-linked immunosorbent assay...
April 18, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#3
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28409761/the-question-of-whether-or-not-to-perform-therapeutic-hypothermia-a-case-of-neonatal-spinal-cord-injury
#4
K Yokoi, S Kobayashi, K Muramatsu, S Suzuki, H Gotou
Neonatal spinal cord injury is an extremely rare perinatal complication that often occurs concurrently with hypoxic ischemic encephalopathy (HIE), further complicating diagnosis of spinal cord injury. Although therapeutic hypothermia for moderate to severe HIE is widely recommended in Japan, it is difficult to determine whether it satisfies the neurological findings-related entry criteria in some patients.We describe a female infant with neonatal spinal cord injury after forceps delivery, who underwent therapeutic hypothermia upon diagnosis of HIE...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28401998/early-discontinuation-of-antiseizure-medications-in-neonates-with-hypoxic-ischemic-encephalopathy
#5
Mark P Fitzgerald, Sudha Kilaru Kessler, Nicholas S Abend
OBJECTIVE: Neonates with hypoxic-ischemic encephalopathy (HIE) managed with therapeutic hypothermia (TH) often experience acute symptomatic seizures, prompting treatment with antiseizure medications (ASMs). Because the risk of seizure occurrence after hospital discharge is unknown, the optimal ASM treatment duration is unclear. We aimed to determine the risk of seizure occurrence after hospital discharge and the impact of ASM treatment duration on this outcome. METHODS: We performed a single-center, retrospective study of consecutive neonates with HIE managed with TH who received ASMs for acute symptomatic seizures from June 2010 through December 2014...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28395175/oxygen-and-oxidative-stress-in-the-perinatal-period
#6
REVIEW
Isabel Torres-Cuevas, Anna Parra-Llorca, Angel Sánchez-Illana, Antonio Nuñez-Ramiro, Julia Kuligowski, Consuelo Cháfer-Pericás, María Cernada, Justo Escobar, Máximo Vento
Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes. In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage...
March 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28391772/intrapartum-fever-and-the-risk-for-perinatal-complications-the-effect-of-fever-duration-and-positive-cultures
#7
Eran Ashwal, Lina Salman, Yossi Tzur, Amir Aviram, Tali Ben-Mayor Bashi, Yariv Yogev, Liran Hiserch
OBJECTIVE: To estimate the association between intrapartum fever and adverse perinatal outcome. METHODS: A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0°C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage...
April 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28390792/delayed-transient-cortical-blindness-from-hypoxic-ischemic-encephalopathy
#8
Kaustubh Limaye, Ashutosh P Jadhav
No abstract text is available yet for this article.
April 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28384785/maternal-body-mass-index-in-early-pregnancy-and-risk-of-epilepsy-in-offspring
#9
Neda Razaz, Kristina Tedroff, Eduardo Villamor, Sven Cnattingius
Importance: There is growing concern about the long-term neurologic effects of prenatal exposure to maternal overweight and obesity. The causes of epilepsy are poorly understood and, in more than 60% of the patients, no definitive cause can be determined. Objectives: To investigate the association between early pregnancy body mass index (BMI) and the risk of childhood epilepsy and examine associations between obesity-related pregnancy and neonatal complications and risks of childhood epilepsy...
April 3, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28383534/the-effect-of-therapeutic-hypothermia-on-heart-rate-variability
#10
Z A Vesoulis, R Rao, S B Trivedi, A M Mathur
OBJECTIVE: Heart rate variability (HRV) reflects integrity of the autonomic nervous system. However, no study has investigated the impact of therapeutic hypothermia (TH) on HRV measures in infants with hypoxic-ischemic encephalopathy (HIE). In this study, we evaluate the influence of temperature on measures of HRV for a group of infants with favorable outcomes, as compared with a control group of infants with unfavorable outcomes. STUDY DESIGN: Term-born infants with moderate-severe HIE underwent standard TH treatment and prospective electroencephalography (EEG) and electrocardiogram (ECG) recording...
April 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28376079/pattern-of-brain-injury-and-depressed-heart-rate-variability-in-newborns-with-hypoxic-ischemic-encephalopathy
#11
Marina Metzler, Rathinaswamy Govindan, Tareq Al-Shargabi, Gilbert Vezina, Nickie Andescavage, Yunfei Wang, Adre du Plessis, An N Massaro
BACKGROUND: Decreased heart rate variability (HRV) is a measure of autonomic dysfunction and brain injury in newborns with hypoxic ischemic encephalopathy (HIE). This study aimed to characterize the relationship between HRV and brain injury pattern by MRI in newborns with HIE undergoing therapeutic hypothermia. METHODS: HRV metrics were quantified in the time domain (αS, αL, and root mean square at short [RMSS] and long [RMSL] time scales) and frequency domain (relative low-[LF] and high-frequency [HF] power) during the time period 24-27 h of life...
April 4, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28374415/biventricular-function-on-early-echocardiograms-in-neonatal-hypoxic-ischemic-encephalopathy
#12
Sanjeev Aggarwal, Girija Natarajan
AIM: To compare early (<24 hours) echocardiograms (ECHOs) in infants with perinatal hypoxic-ischemic encephalopathy (HIE) undergoing a)therapeutic hypothermia (TH) b) normothermia and c) normal controls. METHODS: This was a single center retrospective review of clinical early ECHOs of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right (RVO) and left ventricular output (LVO), RV and LV myocardial performance index (MPI), systolic to diastolic duration ratio (S/D) and eccentricity indices (EI) in systole and diastole were compared using ANOVA...
April 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28369606/comparison-of-two-low-cost-methods-of-cooling-neonates-with-hypoxic-ischemic-encephalopathy
#13
Machilakath Panangandi Shabeer, Thangaraj Abiramalatha, Abhilasha Smith, Pradita Shrestha, Grace Rebekah, Arulmoorthy Meghala, Niranjan Thomas
Background: Several low-cost methods are used in resource-limited settings to provide therapeutic hypothermia in asphyxiated neonates. There is inadequate data about their efficacy and safety. This is a retrospective study comparing two low-cost cooling methods-frozen gel packs (FGP) and phase changing material (PCM). Results: There were 23 babies in FGP and 45 babies in the PCM group. Induction time was significantly shorter with FGP than PCM (45 vs. 90 minutes; p -value < 0...
October 5, 2016: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28359187/prediction-of-future-epilepsy-in-neonates-with-hypoxic-ischemic-encephalopathy-who-received-selective-head-cooling
#14
Tiffani L McDonough, Juliann M Paolicchi, Linda A Heier, Nikkan Das, Murray Engel, Jeffrey M Perlman, Zachary M Grinspan
Epilepsy outcomes after therapeutic hypothermia for neonates with hypoxic-ischemic encephalopathy are understudied. The authors used multivariable logistic regression to predict epilepsy in neonates after selective head cooling. Sensitivity analyses used magnetic resonance imaging (MRI) and electroencephalogram (EEG) interpretations by different clinicians. Fifty neonates had 2-year follow-up. Nine developed epilepsy. Predictors included pH ≤6.8 on day of birth (adjusted odds ratio [OR] 19 [95% confidence interval (CI) 1-371]), burst suppression on EEG on day 4 (8...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28355608/new-wavelet-neurovascular-bundle-for-bedside-evaluation-of-cerebral-autoregulation-and-neurovascular-coupling-in-newborns-with-hypoxic-ischemic-encephalopathy
#15
Lina F Chalak, Rong Zhang
Neonatal encephalopathy (NE) resulting from birth asphyxia constitutes a major global public health burden for millions of infants every year, and despite therapeutic hypothermia, half of these neonates have poor neurological outcomes. As new neuroprotective interventions are being studied in clinical trials, there is a critical need to establish physiological surrogate markers of therapeutic efficacy, to guide patient selection and/or to modify the therapeutic intervention. The challenge in the field of neonatal brain injury has been the difficulty of clinically discerning NE severity within the short therapeutic window after birth or of analyzing the dynamic aspects of the cerebral circulation in sick NE newborns...
March 30, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28351378/melatonin-alleviates-brain-and-peripheral-tissue-edema-in-a-neonatal-rat-model-of-hypoxic-ischemic-brain-damage-the-involvement-of-edema-related-proteins
#16
Li-Xiao Xu, Yuan Lv, Yan-Hong Li, Xin Ding, Ying Wang, Xing Han, Ming-Hua Liu, Bin Sun, Xing Feng
BACKGROUND: Previous studies have indicated edema may be involved in the pathophysiology following hypoxic-ischemic encephalopathy (HIE), and melatonin may exhibit neuro-protection against brain insults. However, little is known regarding the mechanisms that involve the protective effects of melatonin in the brain and peripheral tissues after HIE. The present study aimed to examine the effects of melatonin on multiple organs, and the expression of edema related proteins in a neonatal rat model of hypoxic-ischemic brain damage (HIBD)...
March 28, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28346953/lennox-gastaut-syndrome-a-state-of-the-art-review
#17
Mario Mastrangelo
Lennox-Gastaut syndrome (LGS) is a severe age-dependent epileptic encephalopathy usually with onset between 1 and 8 years of age. Functional neuroimaging studies recently introduced the concept of Lennox-Gastaut as "secondary network epilepsy" resulting from dysfunctions of a complex system involving both cortical and subcortical structures (default-mode network, corticoreticular connections, and thalamus). These dysfunctions are produced by different disorders including hypoxic-ischemic encephalopathies, meningoencephalitis, cortical malformations, neurocutaneous disorders, or tumors...
March 27, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28343228/focal-brain-injury-associated-with-a-model-of-severe-hypoxic-ischemic-encephalopathy-in-nonhuman-primates
#18
Ryan M McAdams, Ronald J McPherson, Raj P Kapur, Sandra E Juul
Worldwide, hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity. To better understand the mechanisms contributing to brain injury and improve outcomes in neonates with HIE, better preclinical animal models that mimic the clinical situation following birth asphyxia in term newborns are needed. In an effort to achieve this goal, we modified our nonhuman primate model of HIE induced by in utero umbilical cord occlusion (UCO) to include postnatal hypoxic episodes, in order to simulate apneic events in human neonates with HIE...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28295535/longer-and-deeper-cooling-for-hypoxic-ischemic-encephalopathy-in-neonates-does-not-reduce-mortality
#19
Dmitry Dukhovny, John A F Zupancic
No abstract text is available yet for this article.
March 12, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#20
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
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