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Neonatal hypoxic ischemic encephalopathy

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https://www.readbyqxmd.com/read/28107263/the-severity-of-hypoxic-ischemic-encephalopathy-correlates-with-multiple-organ-dysfunction-in-the-hypothermia-era
#1
Miguel Alsina, Ana Martín-Ancel, Ana Alarcon-Allen, Gemma Arca, Francisco Gayá, Alfredo García-Alix
OBJECTIVES: The objectives are to 1) determine whether there is a positive correlation between the severity of hypoxic-ischemic encephalopathy and multiple organ dysfunction and 2) evaluate the organ dysfunction pattern in infants with hypoxic-ischemic encephalopathy in the hypothermia era. DESIGN: Retrospective observational study of prospective data collected between April 2009 and December 2012. SETTING: The study took place in the neonatal ICU of Hospital Sant Joan de Déu-Hospital Clínic of Barcelona...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28104944/restricted-diffusion-in-the-corpus-callosum-a-neuroradiological-marker-in-hypoxic-ischemic-encephalopathy
#2
Alok Kale, Priscilla Joshi, A B Kelkar
BACKGROUND: Restricted diffusion within the splenium of the corpus callosum has been described by other authors in various conditions, however, restricted diffusion in the entire corpus callosum or isolated involvement of the splenium, genu, or body has been infrequently reported on magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy. We report a series of cases showing different patterns of involvement. METHODS AND MATERIALS: Perinatal imaging with MRI including diffusion-weighted imaging was performed in 40 neonates with hypoxic-ischemic encephalopathy, including 11 premature neonates...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28103599/evaluations-of-intravenous-administration-of-cd34-human-umbilical-cord-blood-cells-in-a-mouse-model-of-neonatal-hypoxic-ischemic-encephalopathy
#3
Makiko Ohshima, Akihiko Taguchi, Yoshiaki Sato, Yuko Ogawa, Satoshi Saito, Kenichi Yamahara, Masafumi Ihara, Mariko Harada-Shiba, Tomoaki Ikeda, Tomohiro Matsuyama, Masahiro Tsuji
Several cell therapies have been explored as novel therapeutic strategies for neonatal encephalopathy because the benefits of current treatments are limited. We previously reported that intravenous administration of human umbilical cord blood (hUCB) CD34+ cells (hematopoietic stem cells/endothelial progenitor cells) at 48 h after insult exerts therapeutic effects in neonatal mice with stroke, i.e., permanent middle cerebral artery occlusion. Although neonatal stroke and hypoxic-ischemic encephalopathy (HIE) are grouped under the term "neonatal encephalopathy," their pathogenesis differs...
January 20, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28101531/osteopontin-is-a-blood-biomarker-for-microglial-activation-and-brain-injury-in-experimental-hypoxic-ischemic-encephalopathy
#4
Yikun Li, Eric B Dammer, Xiaohui Zhang-Brotzge, Scott Chen, Duc M Duong, Nicholas T Seyfried, Chia-Yi Kuan, Yu-Yo Sun
Clinical management of neonatal hypoxic-ischemic encephalopathy (HIE) suffers from the lack of reliable surrogate marker tests. Proteomic analysis may identify such biomarkers in blood, but there has been no proof-of-principle evidence to support this approach. Here we performed in-gel trypsin digestion of plasma proteins from four groups of 10-d-old mice [untouched and 24 h after low-dose lipopolysaccharide (LPS) exposure, hypoxia-ischemia (HI), or LPS/HI injury; n = 3 in each group) followed by liquid chromatography-tandem mass spectrometry and bioinformatics analysis to search for HI- and LPS/HI-associated brain injury biomarkers...
January 2017: ENeuro
https://www.readbyqxmd.com/read/28099429/vitamin-d-insufficiency-in-neonatal-hypoxic-ischemic-encephalopathy
#5
Danielle W Lowe, Bruce W Hollis, Carol L Wagner, Thomas Bass, David A Kaufman, Michael J Horgan, Laurence M Givelichian, Koravangatta Sankaran, Jerome Y Yager, Lakshmi D Katikaneni, Don Wiest, Dorothea Jenkins
BACKGROUND: Vitamin D has neuroprotective and immunomodulatory properties, and deficiency is associated with worse stroke outcomes. Little is known about effects of hypoxia-ischemia or hypothermia treatment on vitamin D status in neonates with hypoxic-ischemic encephalopathy (HIE). We hypothesized vitamin D metabolism would be dysregulated in neonatal HIE altering specific cytokines involved in Th17 activation, which might be mitigated by hypothermia. METHODS: We analyzed short term relationships between 25(OH) and 1,25(OH)2 vitamin D, vitamin D binding protein, and cytokines related to Th17 function in serum samples from a multicenter randomized controlled trial of hypothermia 33(0)C for 48h after HIE birth versus normothermia in 50 infants with moderate to severe HIE...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28099423/high-dose-erythropoietin-population-pharmacokinetics-in-neonates-with-hypoxic-ischemic-encephalopathy-receiving-hypothermia
#6
Adam Frymoyer, Sandra E Juul, An N Massaro, Theo K Bammler, Yvonne W Wu
BACKGROUND: High-dose erythropoietin (Epo) is a promising neuroprotective treatment in neonates with hypoxic ischemic encephalopathy (HIE) receiving hypothermia. We evaluated the pharmacokinetics and dose-exposure relationships of high-dose Epo in this population to inform future dosing strategies. METHODS: We performed a population pharmacokinetic analysis of 47 neonates with HIE treated with hypothermia who received up to 6 doses of Epo in two previous clinical trials...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28095379/diffusion-tensor-imaging-detects-occult-cerebellar-injury-in-severe-neonatal-hypoxic-ischemic-encephalopathy
#7
Monica E Lemmon, Matthias W Wagner, Thangamadhan Bosemani, Kathryn A Carson, Frances J Northington, Thierry A G M Huisman, Andrea Poretti
BACKGROUND: Despite the benefits of whole-body hypothermia therapy, many infants with hypoxic-ischemic encephalopathy (HIE) die or have significant long-term neurodevelopmental impairment. Prospectively identifying neonates at risk of poor outcome is essential but not straightforward. The cerebellum is not classically considered to be a brain region vulnerable to hypoxic-ischemic insults; recent literature suggests, however, that the cerebellum may be involved in neonatal HIE. In this study, we aimed to assess the microstructural integrity of cerebellar and linked supratentorial structures in neonates with HIE compared to neurologically healthy neonatal controls...
January 18, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28079317/human-umbilical-cord-blood-cd34-positive-cells-as-predictors-of-the-incidence-and-short-term-outcome-of-neonatal-hypoxic-ischemic-encephalopathy-a-pilot-study
#8
Sahar M A Hassanein, Mohamed Hassan Nasr Eldin, Hanaa A Amer, Adel E Abdelhamid, Moustafa El Houssinie, Abir Ibrahim
BACKGROUND AND PURPOSE: Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the leading causes of neurological handicap in developing countries. Human umbilical cord blood (hUCB) CD34-positive (CD34⁺) stem cells exhibit the potential for neural repair. We tested the hypothesis that hUCB CD34⁺ stem cells and other cell types [leukocytes and nucleated red blood cells (NRBCs)] that are up-regulated during the acute stage of perinatal asphyxia (PA) could play a role in the early prediction of the occurrence, severity, and mortality of HIE...
January 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28062175/intranasal-c3a-treatment-ameliorates-cognitive-impairment-in-a-mouse-model-of-neonatal-hypoxic-ischemic-brain-injury
#9
Javier Morán, Anna Stokowska, Frederik R Walker, Carina Mallard, Henrik Hagberg, Marcela Pekna
Perinatal asphyxia-induced brain injury is often associated with irreversible neurological complications such as intellectual disability and cerebral palsy but available therapies are limited. Novel neuroprotective therapies as well as approaches stimulating neural plasticity mechanism that can compensate for cell death after hypoxia-ischemia (HI) are urgently needed. We previously reported that single i.c.v. injection of complement-derived peptide C3a 1h after HI induction prevented HI-induced cognitive impairment when mice were tested as adults...
January 4, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28062149/prediction-of-neonatal-seizures-in-hypoxic-ischemic-encephalopathy-using-electroencephalograph-power-analyses
#10
Siddharth V Jain, Amit Mathur, Preethi Srinivasakumar, Michael Wallendorf, Joseph P Culver, John M Zempel
BACKGROUND: The severity of the initial encephalopathy in neonatal hypoxic-ischemic encephalopathy correlates with seizure burden. Early electroencephalograph (EEG) background activity reflects the severity of encephalopathy. Thus, we hypothesized that early EEG background would be predictive of subsequent seizures in neonatal hypoxic-ischemic encephalopathy. METHODS: This study included infants undergoing therapeutic hypothermia at St. Louis Children's Hospital between January 2009 and April 2013...
November 11, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/28025500/glucocorticoids-protect-neonatal-rat-brain-in-model-of-hypoxic-ischemic-encephalopathy-hie
#11
Benjamin Harding, Katherine Conception, Yong Li, Lubo Zhang
Hypoxic-ischemic encephalopathy (HIE) resulting from asphyxia in the peripartum period is the most common cause of neonatal brain damage and can result in significant neurologic sequelae, including cerebral palsy. Currently therapeutic hypothermia is the only accepted treatment in addition to supportive care for infants with HIE, however, many additional neuroprotective therapies have been investigated. Of these, glucocorticoids have previously been shown to have neuroprotective effects. HIE is also frequently compounded by infectious inflammatory processes (sepsis) and as such, the infants may be more amenable to treatment with an anti-inflammatory agent...
December 22, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28024912/early-diagnosis-and-outcome-prediction-of-neonatal-hypoxic-ischemic-encephalopathy-with-color-doppler-ultrasound
#12
B Guan, C Dai, Y Zhang, L Zhu, X He, N Wang, H Liu
PURPOSE: To describe the ultrasound presentation of the brain and cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy (HIE) by comparison with control subjects. MATERIAL AND METHODS: During June 2012 to April 2013, full term neonates who had clinical evidence of HIE were enrolled. Healthy newborns without HIE were used as a control group. Cerebral parenchyma, size of lateral ventricles and hemodynamic parameters of cerebral arteries were studied using two-dimensional duplex and color Doppler ultrasound...
December 23, 2016: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28018155/neonatal-toxicity-from-escitalopram-use-in-utero-a-case-report
#13
Jessica Degiacomo, Sherry Luedtke
Selective serotonin reuptake inhibitor (SSRI) exposure during pregnancy can result in symptoms of serotonin syndrome or serotonin withdrawal. In contrast to other SSRIs, reports of serotonin behavioral syndrome following in utero exposure to escitalopram and citalopram are limited. We describe a case of suspected toxicity following in utero exposure to 20 mg escitalopram throughout pregnancy. The infant was transferred to our neonatal intensive unit at 9 hours of life for further evaluation of lethargy, weak cry, bradycardia, and non-reactive pupils...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28011948/molecular-hydrogen-affords-neuroprotection-in-a-translational-piglet-model-of-hypoxic-ischemic-encephalopathy
#14
J Nemeth, V Toth-Szuki, V Varga, V Kovacs, G Remzso, F Domoki
Hypoxic-ischemic encephalopathy (HIE) is the major consequence of perinatal asphyxia (PA) in term neonates. Although the newborn piglet is an accepted large animal PA/HIE model, there is no consensus on PA-induction methodology to produce clinically relevant HIE. We aimed to create and to characterize a novel PA model faithfully reproducing all features of asphyxiation including severe hypercapnia resulting in HIE, and to test whether H2 is neuroprotective in this model. Piglets were anaesthetised, artificially ventilated, and intensively monitored (electroencephalography, core temperature, O2 saturation, arterial blood pressure and blood gases)...
October 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28002390/therapeutic-hypothermia-modulates-complement-factor-c3a-and-c5a-levels-in-a-rat-model-of-hypoxic-ischemic-encephalopathy
#15
Tushar A Shah, Jasmine E Nejad, Haree K Pallera, Frank A Lattanzio, Rawad Farhat, Parvathi S Kumar, Pamela S Hair, W Thomas Bass, Neel K Krishna
BACKGROUND: Therapeutic hypothermia (HT) is the only intervention that improves outcomes in neonatal hypoxic-ischemic encephalopathy (HIE). However, the multifactorial mechanisms by which HT impacts HIE are incompletely understood. The complement system plays a major role in the pathogenesis of ischemia-reperfusion injuries such as HIE. We have previously demonstrated that HT modulates complement activity in vitro. METHODS: Term equivalent rat pups were subjected to unilateral carotid ligation followed by hypoxia (8% O2) for 45 minutes to simulate HIE...
December 21, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27993431/the-potentials-and-limitations-of-neuro-biomarkers-as-predictors-of-outcome-in-neonates-with-birth-asphyxia
#16
Angela Satriano, Francesca Pluchinotta, Francesca Gazzolo, Laura Serpero, Diego Gazzolo
Perinatal asphyxia and its complication, hypoxic-ischemic encephalopathy, are still among the major causes of perinatal mortality and morbidity. Despite accurate standard postnatal monitoring procedures, the post-insult period is crucial because at a time when radiologic pictures are still silent, brain damage may already be at a subclinical stage. Against this background, the measurement of quantitative parameters, such as constituents of nervous tissue, that are able to detect subclinical lesions at a stage when routine brain monitoring procedures are still silent, could be particularly useful...
December 16, 2016: Early Human Development
https://www.readbyqxmd.com/read/27988879/therapeutic-hypothermia-for-neonatal-hypoxic-ischemic-encephalopathy-is-associated-with-short-term-reduction-of-seizures-after-discharge-from-the-neonatal-intensive-care-unit
#17
Suman Ghosh, Lily Tran, Jonathan J Shuster, Mary L Zupanc
INTRODUCTION: Therapeutic hypothermia for the treatment of moderate to severe neonatal hypoxic ischemic encephalopathy has been shown to reduce death and disability, but the effects on seizures after discharge from the Neonatal ICU are not known. METHODS: A retrospective cohort study was conducted involving 56 neonates admitted to the Neonatal ICU at Children's Hospital of Orange County, CA from January 1, 2007 to September 1, 2013 with hypoxic ischemic encephalopathy who met criteria for selective brain cooling...
December 17, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27988510/in-the-era-of-therapeutic-hypothermia-how-well-do-studies-of-perinatal-neuroprotection-control-temperature
#18
Robert Galinsky, Justin M Dean, Christopher A Lear, Joanne O Davidson, Simerdeep Dhillon, Guido Wassink, Laura Bennet, Alistair J Gunn
In the era of therapeutic hypothermia, reliable preclinical studies are integral to successfully identify neuroprotective strategies to further improve outcomes of encephalopathy at term. We reviewed preclinical neuroprotection studies reported between January 2014 and June 2016 to assess the use of effective temperature monitoring and control. As a secondary measure, we examined whether studies addressed other methodological issues such as stage of brain development, sex differences, the timing of the treatment relative to the insult, and the histological and functional endpoints used after hypoxia-ischemia...
December 17, 2016: Developmental Neuroscience
https://www.readbyqxmd.com/read/27979578/safety-and-short-term-outcomes-of-therapeutic-hypothermia-in-preterm-neonates-34-35-weeks-gestational-age-with-hypoxic-ischemic-encephalopathy
#19
Rakesh Rao, Shamik Trivedi, Zachary Vesoulis, Steve M Liao, Christopher D Smyser, Amit M Mathur
OBJECTIVE: To evaluate the safety and short-term outcomes of preterm neonates born at 34-35 weeks gestation with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia. STUDY DESIGN: Medical records of preterm neonates born at 34-35 weeks gestational age with HIE treated with therapeutic hypothermia were retrospectively reviewed. Short-term safety outcomes and the presence, severity (mild, moderate, severe), and patterns of brain injury on magnetic resonance imaging were reviewed using a standard scoring system, and compared with a cohort of term neonates with HIE treated with therapeutic hypothermia...
December 13, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27978510/optimizing-cerebral-autoregulation-may-decrease-neonatal-regional-hypoxic-ischemic-brain-injury
#20
Jennifer K Lee, Andrea Poretti, Jamie Perin, Thierry A G M Huisman, Charlamaine Parkinson, Raul Chavez-Valdez, Matthew O'Connor, Michael Reyes, Jillian Armstrong, Jacky M Jennings, Maureen M Gilmore, Raymond C Koehler, Frances J Northington, Aylin Tekes
BACKGROUND: Therapeutic hypothermia provides incomplete neuroprotection for neonatal hypoxic-ischemic encephalopathy (HIE). We examined whether hemodynamic goals that support autoregulation are associated with decreased brain injury and whether these relationships are affected by birth asphyxia or vary by anatomic region. METHODS: Neonates cooled for HIE received near-infrared spectroscopy autoregulation monitoring to identify the mean arterial blood pressure with optimized autoregulatory function (MAPOPT)...
December 16, 2016: Developmental Neuroscience
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