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Neonatal hypoxic ischemic encephalopathy

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https://www.readbyqxmd.com/read/29048405/cooling-in-neonatal-hypoxic-ischemic-encephalopathy-practices-and-opinions-on-minimum-standards-in-the-state-of-california
#1
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/29046881/nmnat3-is-protective-against-the-effects-of-neonatal-cerebral-hypoxia-ischemia
#2
Rafael Galindo, Marianne Banks Greenberg, Toshiyuki Araki, Yo Sasaki, Nehali Mehta, Jeffrey Milbrandt, David M Holtzman
OBJECTIVE: To determine whether the NAD+ biosynthetic protein, nicotinamide mononucleotide adenylyltransferase-3 (NMNAT3), is a neuroprotective inducible enzyme capable of decreasing cerebral injury after neonatal hypoxia-ischemia (H-I) and reducing glutamate receptor-mediated excitotoxic neurodegeneration of immature neurons. METHODS: Using NMNAT3-overexpressing mice we investigated whether increases in brain NMNAT3 reduced cerebral tissue loss following H-I. We then employed biochemical methods from injured neonatal brains to examine the inducibility of NMNAT3 and the mechanism of NMNAT3-dependent neuroprotection...
October 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#3
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/29016557/future-perspectives-of-cell-therapy-for-neonatal-hypoxic-ischemic-encephalopathy
#4
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/28993251/hypoxia-ischemia-modifies-postsynaptic-glun2b-containing-nmda-receptor-complexes-in-the-neonatal-mouse-brain
#5
Fuxin Lu, Guo Shao, Yongqiang Wang, Shenheng Guan, Alma L Burlingame, Xuemei Liu, Xiao Liang, Renatta Knox, Donna M Ferriero, Xiangning Jiang
The N-methyl-d-aspartate-type glutamate receptor (NMDAR)-associated multiprotein complexes are indispensable for synaptic plasticity and cognitive functions. While purification and proteomic analyses of these signaling complexes have been performed in adult rodent and human brain, much less is known about the protein composition of NMDAR complexes in the developing brain and their modifications by neonatal hypoxic-ischemic (HI) brain injury. In this study, the postsynaptic density proteins were prepared from postnatal day 9 naïve, sham-operated and HI-injured mouse cortex...
October 6, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28991764/hypoglycaemia-in-the-newborn
#6
Orhideja Stomnaroska, Elizabeta Petkovska, Sanja Ivanovska, Snezana Jancevska, Dragan Danilovski
AIM: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. PATIENTS AND METHODS: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU)...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28982530/variability-in-preferred-management-of-electrographic-seizures-in-neonatal-hypoxic-ischemic-encephalopathy
#7
Melanie A McNally, Adam L Hartman
BACKGROUND: Seizures may cause added harm in neonates with hypoxic-ischemic encephalopathy (HIE). Specific recommendations about seizure treatment in this context are lacking. We sought to determine the scope of practice regarding management of non-status epilepticus electrographic-only seizures in this setting. METHODS: A case-based survey was distributed to members of the Child Neurology Society. Providers were asked about their preferred management strategy for sequential clinical scenarios...
June 15, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28981488/from-cord-to-caudate-characterizing-umbilical-cord-blood-stem-cells-and-their-paracrine-interactions-with-the-injured-brain
#8
REVIEW
Priya F Maillacheruvu, Lauren M Engel, Isaiah T Crum, Devendra K Agrawal, Eric S Peeples
Stem cells are proving to be a promising therapy for a wide range of pediatric disorders, from neonatal hypoxic-ischemic encephalopathy to pediatric leukemia. Due to their low immunogenicity and ease of availability, umbilical cord blood (UCB) progenitor cells are increasingly replacing fetal and adult-derived cells in therapeutic settings. Multiple environmental and demographic factors affect the number and type of stem cells extracted from UCB, and these differences have been associated with disparities in outcomes after transplantation...
October 5, 2017: Pediatric Research
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
#9
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...
October 5, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28972960/strategies-to-enhance-paracrine-potency-of-transplanted-mesenchymal-stem-cells-in-intractable-neonatal-disorders
#10
REVIEW
Won Soon Park, So Yoon Ahn, Se In Sung, Jee-Yin Ahn, Yun Sil Chang
Mesenchymal stem cell (MSC) transplantation represents the next breakthrough in the treatment of currently intractable and devastating neonatal disorders with complex multifactorial etiologies, including bronchopulmonary dysplasia, hypoxic ischemic encephalopathy, and intraventricular hemorrhage. Absent engraftment and direct differentiation of transplanted MSCs, and the 'hit and run' therapeutic effects of these MSCs suggest that their pleiotropic protection might be attributable to paracrine activity via the secretion of various biologic factors rather than to regenerative activity...
October 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28962807/targeted-temperature-management-in-brain-injured-patients
#11
REVIEW
Fred Rincon
Evidence from animal models indicates that lowering temperature by a few degrees can produce substantial neuroprotection. In humans, hypothermia has been found to be neuroprotective with a significant impact on mortality and long-term functional outcome only in cardiac arrest and neonatal hypoxic-ischemic encephalopathy. Clinical trials have explored the potential role of maintaining normothermia and treating fever in critically ill brain injured patients. This review concentrates on basic concepts to understand the physiologic interactions of thermoregulation, effects of thermal modulation in critically ill patients, proposed mechanisms of action of temperature modulation, and practical aspects of targeted temperature management...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28960438/evaluating-a-targeted-bedside-measure-of-cerebral-perfusion-in-a-nonhuman-primate-model-of-neonatal-hypoxic-ischemic-encephalopathy
#12
Eric S Peeples, Chikodinaka K Ezeokeke, Sandra E Juul, Pierre D Mourad
OBJECTIVES: To compare ultrasound-derived resistive indices (RIs) obtained at the level of the thalamus via fast Doppler ultrasound with traditional anterior cerebral artery measures in a model of neonatal hypoxic-ischemic encephalopathy and to correlate each with clinical outcomes. METHODS: Nine nonhuman primate neonates underwent no umbilical cord occlusion (n = 3), umbilical cord occlusion without hypothermia (n = 3), or umbilical cord occlusion with hypothermia (n = 3)...
September 29, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28942555/the-applicability-of-amide-proton-transfer-imaging-in-the-nervous-system-focus-on-hypoxic-ischemic-encephalopathy-in-the-neonate
#13
REVIEW
Yang Zheng, Xiaoming Wang
In recent years, magnetic resonance imaging (MRI) has become more widely used in neonatal hypoxic-ischemic encephalopathy (HIE), involving, for example, evaluation of cerebral edema, white matter fiber bundle tracking, cerebral perfusion status, and assessment of brain metabolites. MRI has many imaging modalities. However, its application for assessing changes in the internal environment at the tissue and cellular level after hypoxia-ischemia remains a challenge and is currently the focus of intense research...
September 23, 2017: Cellular and Molecular Neurobiology
https://www.readbyqxmd.com/read/28938291/feasibility-and-safety-of-controlled-active-hypothermia-treatment-during-transport-in-neonates-with-hypoxic-ischemic-encephalopathy
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/28925896/allopurinol-old-drug-new-indication-in-neonates
#17
Kim V Annink, Axel R Franz, Jan B Derks, Mario Rüdiger, Frank van Bel, Manon J N L Benders
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is an important cause of neonatal mortality and neurological morbidity, even despite hypothermia treatment. Neuronal damage in these infants is partly caused by the production of superoxides via the xanthine-oxidase pathway and concomitant free radical formation. Allopurinol is a xanthine-oxidase inhibitor and can potentially reduce the formation of these superoxides that lead to brain damage in HIE. METHODS: The aim of this review is to provide an overview of the animal and clinical data about the neuroprotective effect of allopurinol in HIE and the relevant mechanisms leading to brain injury in HIE...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28925315/prognostic-value-of-brain-magnetic-resonance-imaging-in-neonatal-hypoxic-ischemic-encephalopathy-a-meta-analysis
#18
Iván Sánchez Fernández, J Leon Morales-Quezada, Samuel Law, Paggie Kim
OBJECTIVE: To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy. METHODS: Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemic encephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months. RESULTS: An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28867032/-revelation-of-the-circumstances-of-the-accident-vascular-arterial-ischemic-brain-in-at-term-or-near-term-and-referral
#19
F Cneude, J-F Diependaele, J-L Chabernaud
The neonatal arterial ischemic stroke is an emergency. Recurrent focal seizures, generally occurring in the first 24-72 hours after birth, are the commonest first clinical signs. When neonatal arterial ischemic stroke is suspected, optimal initial management involves careful supportive care including treatment of clinical and frequent or prolonged subclinical seizures, correction of the possible metabolic disorders and their prevention. Contrary to hypoxic ischemic encephalopathy, therapeutic hypothermia is not indicated...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28860770/early-predictors-of-brain-damage-in-full-term-newborns-with-hypoxic-ischemic-encephalopathy
#20
Usama M Alkholy, Nermin Abdalmonem, Ahmed Zaki, Yasser F Ali, Soma Abdalla Mohamed, Nasser I Abdelsalam, Mustafa Ismail Abu Hashim, Mohamed Abou Sekkien, Yasser Makram Elsherbiny
OBJECTIVE OF THE STUDY: To evaluate the value of serum creatine phosphokinase-brain specific (CK-BB) and urinary lactate/creatinine (L/C) ratio as early indicators of brain damage in full-term newborns with hypoxic ischemic encephalopathy (HIE). PATIENTS AND METHODS: A case-control study including 25 full-term new-born infants with perinatal asphyxia who were admitted to neonatal intensive care unit (NICU) with a proven diagnosis of HIE, compared to 20 healthy age- and sex-matched full-term newborns...
2017: Neuropsychiatric Disease and Treatment
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