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therapeutic hypothermia in neonates

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https://www.readbyqxmd.com/read/29926474/neonatal-interventions-for-preventing-cerebral-palsy-an-overview-of-cochrane-systematic-reviews
#1
REVIEW
Emily Shepherd, Rehana A Salam, Philippa Middleton, Shanshan Han, Maria Makrides, Sarah McIntyre, Nadia Badawi, Caroline A Crowther
BACKGROUND: Cerebral palsy is an umbrella term that encompasses disorders of movement and posture attributed to non-progressive disturbances occurring in the developing foetal or infant brain. As there are diverse risk factors and aetiologies, no one strategy will prevent cerebral palsy. Therefore, there is a need to systematically consider all potentially relevant interventions for prevention. OBJECTIVES: PrimaryTo summarise the evidence from Cochrane Systematic Reviews regarding effects of neonatal interventions for preventing cerebral palsy (reducing cerebral palsy risk)...
June 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29920306/pregnancy-as-a-valuable-period-for-preventing-hypoxia-ischemia-brain-damage
#2
REVIEW
C A Netto, E F Sanches, F Odorcyk, L E Duran-Carabali, S V Sizonenko
Neonatal brain Hypoxia-Ischemia (HI) is one of the major causes of infant mortality and lifelong neurological disabilities. The knowledge about the physiopathological mechanisms involved in HI lesion have increased in recent years, however these findings have not been translated into clinical practice. Current therapeutic approaches remain limited; hypothermia, used only in term or near-term infants, is the golden standard. Epidemiological evidence shows a link between adverse prenatal conditions and increased risk for diseases, health problems, and psychological outcomes later in life, what makes pregnancy a relevant period for preventing future brain injury...
June 16, 2018: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/29895836/predictive-value-of-early-eeg-for-seizures-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia
#3
Marie-Coralie Cornet, Archana Pasupuleti, Annie Fang, Fernando Gonzalez, Thomas Shimotake, Donna Marie Ferriero, Hannah Cranley Glass, Maria Roberta Cilio
OBJECTIVES: To assess the prognostic significance of an early normal/mildly abnormal conventional EEG (cEEG) on seizure risk in neonates undergoing therapeutic hypothermia. METHODS: We reviewed the video-EEG recordings from a large cohort of neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy from 2008 to 2017 in a single tertiary center. Continuous video-EEG was started as soon as possible (median 8.2 h) and continued throughout hypothermia and rewarming...
May 3, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29875342/anti-cytokine-therapy-to-attenuate-ischemic-reperfusion-associated-brain-injury-in-the-perinatal-period
#4
REVIEW
Clémence Disdier, Xiaodi Chen, Jeong-Eun Kim, Steven W Threlkeld, Barbara S Stonestreet
Perinatal brain injury is a major cause of morbidity and long-standing disability in newborns. Hypothermia is the only therapy approved to attenuate brain injury in the newborn. However, this treatment is unfortunately only partially neuroprotective and can only be used to treat hypoxic-ischemic encephalopathy in full term infants. Therefore, there is an urgent need for adjunctive therapeutic strategies. Post-ischemic neuro-inflammation is a crucial contributor to the evolution of brain injury in neonates and constitutes a promising therapeutic target...
June 7, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29868521/measuring-near-infrared-spectroscopy-derived-cerebral-autoregulation-in-neonates-from-research-tool-toward-bedside-multimodal-monitoring
#5
REVIEW
Liesbeth Thewissen, Alexander Caicedo, Petra Lemmers, Frank Van Bel, Sabine Van Huffel, Gunnar Naulaers
Introduction: Cerebral autoregulation (CAR), the ability of the human body to maintain cerebral blood flow (CBF) in a wide range of perfusion pressures, can be calculated by describing the relation between arterial blood pressure (ABP) and cerebral oxygen saturation measured by near-infrared spectroscopy (NIRS). In literature, disturbed CAR is described in different patient groups, using multiple measurement techniques and mathematical models. Furthermore, it is unclear to what extent cerebral pathology and outcome can be explained by impaired CAR...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29867720/early-detection-of-hypothermic-neuroprotection-using-t2-weighted-magnetic-resonance-imaging-in-a-mouse-model-of-hypoxic-ischemic-encephalopathy
#6
Sydney E Doman, Akanksha Girish, Christina L Nemeth, Gabrielle T Drummond, Patrice Carr, Maxine S Garcia, Michael V Johnston, Sujatha Kannan, Ali Fatemi, Jiangyang Zhang, Mary Ann Wilson
Perinatal hypoxic-ischemic encephalopathy (HIE) can lead to neurodevelopmental disorders, including cerebral palsy. Standard care for neonatal HIE includes therapeutic hypothermia, which provides partial neuroprotection; magnetic resonance imaging (MRI) is often used to assess injury and predict outcome after HIE. Immature rodent models of HIE are used to evaluate mechanisms of injury and to examine the efficacy and mechanisms of neuroprotective interventions such as hypothermia. In this study, we first confirmed that, in the CD1 mouse model of perinatal HIE used for our research, MRI obtained 3 h after hypoxic ischemia (HI) could reliably assess initial brain injury and predict histopathological outcome...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29867713/cerebral-lactate-concentration-in-neonatal-hypoxic-ischemic-encephalopathy-in-relation-to-time-characteristic-of-injury-and-serum-lactate-concentration
#7
Tai-Wei Wu, Benita Tamrazi, Kai-Hsiang Hsu, Eugenia Ho, Aaron J Reitman, Matthew Borzage, Stefan Blüml, Jessica L Wisnowski
Background: Cerebral lactate concentration can remain detectable in neonatal hypoxic-ischemic encephalopathy (HIE) after hemodynamic stability. The temporal resolution of regional cerebral lactate concentration in relation to the severity or area of injury is unclear. Furthermore, the interplay between serum and cerebral lactate in neonatal HIE has not been well defined. The study aims to describe cerebral lactate concentration in neonatal HIE in relation to time, injury, and serum lactate...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29866591/renal-saturation-and-acute-kidney-injury-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia
#8
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/29858987/neurologic-and-cognitive-outcomes-associated-with-the-clinical-use-of-xenon-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Lawrence Siu-Chun Law, Elaine Ah-Gi Lo, Caspar Chi-Chung Chan, Tong Joo Gan
BACKGROUND: Xenon has been shown to have positive neurologic effects in various pre-clinical models. This study systematically reviewed the randomized-controlled trials (RCTs) investigating neurologic and cognitive outcomes associated with the clinical use of xenon. METHODS: We searched PubMed, CENTRAL, EMBASE, CINAHL, elibrary.ru (for Russian studies), Google Scholar (for Russian studies), and Wanfang (for Chinese studies) for appropriate RCTs comparing neurologic or cognitive outcomes after clinical use of xenon with control treatment or with other anesthetic agents...
June 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29843267/impact-of-a-neuro-intensive-care-service-for-newborns
#10
M J Harbert, R Sey, K Arnell, L Salinda, M K Brown, D Lazarus, D M Poeltler, P R Wozniak, M R Rasmussen
BACKGROUND: Advances in treating the injured neonatal brain have given rise to neuro-intensive care services for newborns. This study assessed the impact of one such service in a cohort of newborns treated with therapeutic hypothermia. METHODS: Our newborn neuro-intensive care service was started in November 2012. From January 2008 to October 2016, a cohort of 158 newborns was treated with therapeutic hypothermia, 29 before and 129 after the inception of the service...
May 23, 2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29795315/association-between-sedation-analgesia-and-neurodevelopment-outcomes-in-neonatal-hypoxic-ischemic-encephalopathy
#11
Girija Natarajan, Seetha Shankaran, Abbot R Laptook, Scott A McDonald, Athina Pappas, Susan R Hintz, Abhik Das
OBJECTIVE: To evaluate the association between sedation-analgesia (SA) during initial 72 h and death/disability at 18 months of age in neonatal hypoxic-ischemic encephalopathy (HIE). DESIGN: This was a secondary analysis of the NICHD therapeutic hypothermia (TH) randomized controlled trial in moderate or severe HIE. Receipt of SA and anticonvulsant medications at five time points were considered: prior to and at baseline, 24, 48, and 72 h of TH or normothermia...
May 24, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29781223/delayed-injury-of-hippocampal-interneurons-after-neonatal-hypoxia-ischemia-and-therapeutic-hypothermia-in-a-murine-model
#12
Raul Chavez-Valdez, Paul Emerson, Janasha Goffigan-Holmes, Alfredo Kirkwood, Lee J Martin, Frances J Northington
Delayed hippocampal injury and memory impairments follow neonatal hypoxia-ischemia (HI) despite the use of therapeutic hypothermia (TH). Death of hippocampal pyramidal cells occurs acutely after HI, but characterization of delayed cell death and injury of interneurons (INs) is unknown. We hypothesize that injury of INs after HI is: i) asynchronous to that of pyramidal cells, ii) independent of injury severity, and iii) unresponsive to TH. HI was induced in C57BL6 mice at p10 with unilateral right carotid ligation and 45 min of hypoxia (FiO2 =0...
May 21, 2018: Hippocampus
https://www.readbyqxmd.com/read/29775114/oxygen-dependency-of-mitochondrial-metabolism-indicates-outcome-of-newborn-brain-injury
#13
Gemma Bale, Subhabrata Mitra, Isabel de Roever, Magdalena Sokolska, David Price, Alan Bainbridge, Roxana Gunny, Cristina Uria-Avellanal, Giles S Kendall, Judith Meek, Nicola J Robertson, Ilias Tachtsidis
There is a need for a method of real-time assessment of brain metabolism during neonatal hypoxic-ischaemic encephalopathy (HIE). We have used broadband near-infrared spectroscopy (NIRS) to monitor cerebral oxygenation and metabolic changes in 50 neonates with HIE undergoing therapeutic hypothermia treatment. In 24 neonates, 54 episodes of spontaneous decreases in peripheral oxygen saturation (desaturations) were recorded between 6 and 81 h after birth. We observed differences in the cerebral metabolic responses to these episodes that were related to the predicted outcome of the injury, as determined by subsequent magnetic resonance spectroscopy derived lactate/N-acetyl-aspartate...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29769612/hypothermia-broadens-the-therapeutic-time-window-of-mesenchymal-stem-cell-transplantation-for-severe-neonatal-hypoxic-ischemic-encephalopathy
#14
So Yoon Ahn, Yun Sil Chang, Dong Kyung Sung, Se In Sung, Won Soon Park
Recently, we have demonstrated that concurrent hypothermia and mesenchymal stem cells (MSCs) transplantation synergistically improved severe neonatal hypoxic ischemic encephalopathy (HIE). The current study was designed to determine whether hypothermia could extend the therapeutic time window of MSC transplantation for severe neonatal HIE. To induce HIE, newborn rat pups were exposed to 8% oxygen for 2 h following unilateral carotid artery ligation on postnatal day (P) 7. After approving severe HIE involving >50% of the ipsilateral hemisphere volume, hypothermia (32 °C) for 2 days was started...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29747886/therapeutic-hypothermia-how-can-we-optimize-this-therapy-to-further-improve-outcomes
#15
REVIEW
Girija Natarajan, Abbot Laptook, Seetha Shankaran
Neonatal hypoxic-ischemic encephalopathy remains associated with considerable death and disability. In multiple randomized controlled trials, therapeutic hypothermia for neonatal moderate or severe hypoxic-ischemic encephalopathy among term infants has been shown to be safe and effective in reducing death and disability in survivors. In this article, the current status of infant and childhood outcomes following this therapy is reviewed. The clinical approaches that may help to optimize this innovative neuroprotective therapy are presented...
June 2018: Clinics in Perinatology
https://www.readbyqxmd.com/read/29740186/exploring-parent-expectations-of-neonatal-therapeutic-hypothermia
#16
Alexa K Craig, Roslyn Gerwin, Janelle Bainter, Scott Evans, Christine James
OBJECTIVE: We aimed to assess the parent experience of therapeutic hypothermia (TH), specifically focusing on unmet expectations. STUDY DESIGN: Open-ended questions were used in a focus group setting. We employed an inductive approach to develop thematic content from the transcribed recordings. RESULTS: 30 parents of infants treated with TH participated. Within the principal theme of managing expectations, four sub-themes emerged. These included parental concerns about morphine use; specifically the association of morphine with end-of-life care and addiction...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29737915/correlations-of-enzyme-levels-at-birth-in-stressed-neonates-with-short-term-outcomes
#17
Junya Nakajima, Norito Tsutsumi, Shonosuke Nara, Hiroki Ishii, Yusuke Suganami, Daisuke Sunohara, Hisashi Kawashima
INTRODUCTION: Multi-organ injury causes leakage of several intracellular enzymes into the circulation. We evaluated the correlation between the serum-leaked intracellular enzyme levels at the beginning of treatment and the outcome in perinatally stressed neonates. MATERIALS AND METHODS: We retrospectively studied neonates whose 1 minute Apgar score was < 7. We collected initial venous blood sample data, including aspartate transaminase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) levels, and correlated these with patient short-term outcomes...
May 8, 2018: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/29732456/a-quality-initiative-for-optimal-therapeutic-hypothermia-during-transport-for-neonates-with-neonatal-encephalopathy
#18
Stephanie L Bourque, Stephanie A Meier, Claire Palmer, Diane L Melara, Theresa R Grover, Cassidy A Delaney
Introduction: Neuroprotection with therapeutic hypothermia (TH) is standard of care for neonatal encephalopathy (NE) and decreases death and neurodevelopmental disability. TH initiated shortly after birth insult results in greater neuroprotection compared with delayed initiation. Methods: Quality improvement methodology was used to improve temperature control during transport to a level IV neonatal intensive care unit. We included neonates with NE transported to a single institution for TH from 2010 to 2016...
March 2018: Pediatric quality & safety
https://www.readbyqxmd.com/read/29731237/recent-advances-in-preclinical-and-clinical-multimodal-mr-in-the-newborn-brain
#19
Vicente Enguix, Yang Ding, Gregory A Lodygensky
Aside from injury identification, MRI of the newborn brain has given us insight into cortical and white matter development, identified windows of vulnerabilities, enabled the introduction of therapeutic hypothermia which has become the standard of care in neonatal asphyxia, and is fostering leapfrogging discoveries in the field of neuro-genetics. This article reviews the main advances in recent years in newborn brain imaging both in preclinical and clinical research.
April 30, 2018: Journal of Magnetic Resonance
https://www.readbyqxmd.com/read/29725319/nitric-oxide-synthase-inhibition-as-a-neuroprotective-strategy-following-hypoxic-ischemic-encephalopathy-evidence-from-animal-studies
#20
REVIEW
Laurent M A Favié, Arlette R Cox, Agnes van den Hoogen, Cora H A Nijboer, Cacha M P C D Peeters-Scholte, Frank van Bel, Toine C G Egberts, Carin M A Rademaker, Floris Groenendaal
Background: Hypoxic-ischemic encephalopathy following perinatal asphyxia is a leading cause of neonatal death and disability worldwide. Treatment with therapeutic hypothermia reduced adverse outcomes from 60 to 45%. Additional strategies are urgently needed to further improve the outcome for these neonates. Inhibition of nitric oxide synthase (NOS) is a potential neuroprotective target. This article reviews the evidence of neuroprotection by nitric oxide (NO) synthesis inhibition in animal models...
2018: Frontiers in Neurology
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