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therapeutic hypothermia in neonates

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https://www.readbyqxmd.com/read/29681183/neonatal-hypoxic-ischemic-encephalopathy-emerging-therapeutic-strategies-based-on-pathophysiologic-phases-of-the-injury
#1
Qiuli Wang, Hongyan Lv, Lixin Lu, Pengshun Ren, Lianxiang Li
Neonatal hypoxic ischemic encephalopathy (HIE) is an important cause of neonatal death and disability. At present, there is no unified standard and specialized treatment method for neonatal HIE. In clinical practice, we have found that a gap remains between preclinical medical research and clinical application in treatment of neonatal HIE. To promote an organic combination of preclinical research and clinical application, we propose the different phases as intervention targets, based on the pathophysiologic changes in phases I, II, and III of neonatal HIE; moreover, we suggest transformative medicine as a principle that may improve the therapeutic effect by blocking the progression of the disease to an irreversible stage...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29648595/progesterone-as-a-postnatal-prophylactic-agent-for-encephalopathy-caused-by-prenatal-hypoxic-ischemic-insult
#2
Yoshimasa Kawarai, Hirokazu Tanaka, Tatsuya Kobayashi, Makio Shozu
Brain damage caused by hypoxic ischemic insult during the perinatal period causes hypoxic ischemic encephalopathies (HIEs). Therapeutic hypothermia is indicated for HIE, but since the therapeutic burden is large for its limited therapeutic effectiveness, another strategy is needed. Progesterone (P4) plays a neuroprotective role through the actions of its metabolite, allopregnanolone (Allo), on P4 receptor, GABA (γ-aminobutyric acid)A receptors or both. We examined the therapeutic potential of P4 using a newborn rat model of HIE...
April 10, 2018: Endocrinology
https://www.readbyqxmd.com/read/29629693/therapeutic-hypothermia-in-neonates-is-phase-changing-material-the-game-changer
#3
EDITORIAL
Sriparna Basu, Manish Kumar
No abstract text is available yet for this article.
March 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29595551/exploring-parent-experience-of-communication-about-therapeutic-hypothermia-in-the-neonatal-intensive-care-unit
#4
Alexa K Craig, Roslyn Gerwin, Janelle Bainter, Scott Evans, Christine James
BACKGROUND: The unique communication challenges faced by parents of infants undergoing therapeutic hypothermia have not been well characterized. PURPOSE: To develop awareness of communication challenges experienced by families of infants treated with therapeutic hypothermia. METHODS: Semistructured interviews were conducted in a group setting with parents matched into groups according to the severity of the infant's presenting encephalopathy...
April 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29571928/hemodynamic-changes-during-rewarming-phase-of-whole-body-hypothermia-therapy-in-neonates-with-hypoxic-ischemic-encephalopathy
#5
Tai-Wei Wu, Benita Tamrazi, Sadaf Soleymani, Istvan Seri, Shahab Noori
OBJECTIVE: To delineate the systemic and cerebral hemodynamic response to incremental increases in core temperature during the rewarming phase of therapeutic hypothermia in neonatal hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: Continuous hemodynamic data, including heart rate (HR), mean arterial blood pressure (MBP), cardiac output by electrical velocimetry (COEV ), arterial oxygen saturation, and renal (RrSO2 ) and cerebral (CrSO2 ) regional tissue oxygen saturation, were collected from 4 hours before the start of rewarming to 1 hour after the completion of rewarming...
March 20, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29562588/pretreatment-with-group-ii-metabotropic-glutamate-receptor-agonist-ly379268-protects-neonatal-rat-brains-from-oxidative-stress-in-an-experimental-model-of-birth-asphyxia
#6
Ewelina Bratek, Apolonia Ziembowicz, Elzbieta Salinska
Hypoxia-ischemia (H-I) at the time of birth may cause neonatal death or lead to persistent brain damage. The search for an effective treatment of asphyxiated infants has not resulted in an effective therapy, and hypothermia remains the only available therapeutic strategy. Among possible experimental therapies, the induction of ischemic tolerance is promising. Recent investigations have shown that activation of group II metabotropic glutamate receptors (mGluR2/3) can provide neuroprotection against H-I, but the mechanism of this effect is not clear...
March 17, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29561203/n-acetylcysteine-rapidly-replenishes-central-nervous-system-glutathione-measured-via-magnetic-resonance-spectroscopy-in-human-neonates-with-hypoxic-ischemic-encephalopathy
#7
Hunter G Moss, Truman R Brown, Donald B Wiest, Dorothea D Jenkins
Persistent oxidative stress depletes reduced glutathione (GSH), an intracellular antioxidant and an important determinant of CNS injury after hypoxia ischemia. We used standard, short echo time Stimulated Echo Acquisition Mode (STEAM) to detect GSH by magnetic resonance spectroscopy (MRS) in 24 term neonates with hypoxic-ischemic encephalopathy (HIE), on day of life 5-6, after rewarming from therapeutic hypothermia. MRS demonstrated reliable, consistent GSH of 1·64 ± 0·20 mM in the basal ganglia immediately before intravenous infusion of N-acetylcysteine...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29519539/autonomic-dysfunction-in-neonates-with-hypoxic-ischemic-encephalopathy-undergoing-therapeutic-hypothermia-impairs-physiological-responses-to-routine-care-events
#8
Heather Campbell, Rathinaswamy B Govindan, Srinivas Kota, Tareq Al-Shargabi, Marina Metzler, Nickie Andescavage, Taeun Chang, Gilbert Vezina, Adre du Plessis, An N Massaro
OBJECTIVE: To evaluate whether infants with hypoxic-ischemic encephalopathy and evidence of autonomic dysfunction have aberrant physiological responses to care events that could contribute to evolving brain injury. STUDY DESIGN: Continuous tracings of heart rate (HR), blood pressure (BP), cerebral near infrared spectroscopy, and video electroencephalogram data were recorded from newborn infants with hypoxic-ischemic encephalopathy who were treated with hypothermia...
March 6, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29514165/high-dose-erythropoietin-for-asphyxia-and-encephalopathy-heal-a-randomized-controlled-trial-background-aims-and-study-protocol
#9
Sandra E Juul, Bryan A Comstock, Patrick J Heagerty, Dennis E Mayock, Amy M Goodman, Stephanie Hauge, Fernando Gonzalez, Yvonne W Wu
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) remains an important cause of neonatal death and frequently leads to significant long-term disability in survivors. Therapeutic hypothermia, while beneficial, still leaves many treated infants with lifelong disabilities. Adjunctive therapies are needed, and erythropoietin (Epo) has the potential to provide additional neuroprotection. OBJECTIVES: The aim of this study was to review the current incidence, mechanism of injury, and sequelae of HIE, and to describe a new phase III randomized, placebo-controlled trial of Epo neuroprotection in term and near-term infants with moderate to severe HIE treated with therapeutic hypothermia...
March 7, 2018: Neonatology
https://www.readbyqxmd.com/read/29504433/therapeutic-hypothermia-for-neonatal-hypoxic-ischemic-encephalopathy-magnetic-resonance-imaging-findings-and-neurological-outcomes-in-a-brazilian-cohort
#10
Renato S Procianoy, Andrea Lucia A Corso, Maria Gabriela Longo, Leonardo Vedolin, Rita C Silveira
OBJECTIVE: To determine the neurodevelopment outcomes after Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy (HIE) and identify the neonatal Magnetic Resonance Imaging (MRI) findings associated with neurological outcome in a middle-income country. STUDY DESIGN: All infants born after 35 completed weeks' gestation with signs of moderate to severe encephalopathy and evidence of perinatal asphyxia before 6 hours of life were submitted to whole-body hypothermia and were imaged at 18 ± 8...
March 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29487351/predicting-the-need-for-home-gavage-or-g-tube-feeds-in-asphyxiated-neonates-treated-with-therapeutic-hypothermia
#11
Suneeti Gupta, Jayapalli Rajiv Bapuraj, Gabrielle Carlson, Emily Trumpower, Ronald E Dechert, Subrata Sarkar
BACKGROUND: Asphyxiated infants treated with therapeutic cooling can have persistent oral feeding difficulty because of involvement of neural pathways in the brainstem, cortex, and basal ganglia. The goal is to predict the composite adverse outcome of death or persistent oral feeding difficulty using precooling/cooling attributes, and the severity and distribution of hypoxic-ischemic lesions, especially brainstem lesions on post-cooling brain magnetic resonance imaging (MRI). METHODS: Retrospective review of 86 asphyxiated infants cooled from January 2006 to August 2014...
February 27, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29480945/critically-ill-neonates-displayed-stable-vital-parameters-and-reduced-metabolic-acidosis-during-neonatal-emergency-airborne-transport-in-sweden
#12
Ingrid Frid, Johan Ågren, Mattias Kjellberg, Erik Normann, Richard Sindelar
AIM: This study evaluated the medical quality of acute airborne transports carried out by a neonatal emergency transport service in a Swedish healthcare region from 2012-2015. METHODS: The transport charts and patient records of all infants transported to the regional centre were reviewed for transport indications and vital parameters and outcomes. RESULTS: We identified 187 acute airborne transports and the main indications for referral were therapeutic hypothermia after perinatal asphyxia, extremely preterm birth and respiratory failure...
February 26, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29479231/initiation-of-passive-cooling-at-referring-centre-is-most-predictive-of-achieving-early-therapeutic-hypothermia-in-asphyxiated-newborns
#13
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/29476891/post-arrest-therapeutic-hypothermia-in-pediatric-patients-with-congenital-heart-disease
#14
Henry H Cheng, Satish K Rajagopal, Arnold J Sansevere, Erica McDavitt, Daniel Wigmore, Jessica Mecklosky, Kristofer Andren, Kathryn A Williams, Amy Danehy, Janet S Soul
BACKGROUND: While therapeutic hypothermia (TH) is an effective neuroprotective therapy for neonatal hypoxic-ischemic encephalopathy, TH has not been demonstrated to improve outcome in other pediatric populations. Patients with acquired or congenital heart disease (CHD) are at high risk of both cardiac arrest and neurodevelopmental impairments, and therapies are needed to improve neurologic outcome. The primary goal of our study was to compare safety/efficacy outcomes in post-arrest CHD patients treated with TH versus controls not treated with TH...
February 21, 2018: Resuscitation
https://www.readbyqxmd.com/read/29476789/behavioral-and-neuroanatomical-outcomes-in-a-rat-model-of-preterm-hypoxic-ischemic-brain-injury-effects-of-caffeine-and-hypothermia
#15
Molly Potter, Ted Rosenkrantz, R Holly Fitch
The current study investigated behavioral and post mortem neuroanatomical outcomes in Wistar rats with a neonatal hypoxic-ischemic (HI) brain injury induced on postnatal day 6 (P6; Rice-Vannucci HI method; Rice et al., 1981). This preparation models brain injury seen in premature infants (gestational age (GA) 32-35 weeks) based on shared neurodevelopmental markers at time of insult, coupled with similar neuropathologic sequelae (Rice et al., 1981; Workman et al., 2013). Clinically, HI insult during this window is associated with poor outcomes that include attention deficit hyperactivity disorder (ADHD), motor coordination deficits, spatial memory deficits, and language/learning disabilities...
February 21, 2018: International Journal of Developmental Neuroscience
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...
February 23, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29472708/no-question-too-small-development-of-a-question-prompt-list-for-parents-of-critically-ill-infants
#17
Monica E Lemmon, Pamela K Donohue, Erin P Williams, Debra Brandon, Peter A Ubel, Renee D Boss
OBJECTIVE: To develop a question prompt list tailored to the needs of parents of critically ill infants at risk of neurodevelopmental impairment. STUDY DESIGN: Question content was derived from audio-recorded neonatal intensive care unit family meetings and interviews with parents of infants treated with therapeutic hypothermia. Question content was refined using clinician focus groups. Acceptability testing was performed with parents and clinicians caring for infants in the neonatal intensive care unit...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29471782/transcapillary-fluid-flux-and-inflammatory-response-during-neonatal-therapeutic-hypothermia-an-open-longitudinal-observational-study
#18
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/29466895/altered-plasma-type-gelsolin-and-amyloid-%C3%AE-in-neonates-with-hypoxic-ischaemic-encephalopathy-under-therapeutic-hypothermia
#19
Isabel Benavente-Fernandez, Juan J Ramos-Rodriguez, Carmen Infante-Garcia, Gema Jimenez-Gomez, Alfonso Lechuga-Sancho, Simon Lubian-Lopez, Monica Garcia-Alloza
Hypoxic-ischemic encephalopathy (HIE) is a severe neonatal complication responsible for ∼23% of all neonatal deaths. Also, 30-70% of these patients will suffer lifetime disabilities, including learning impairment, epilepsy or cerebral palsy. However, biomarkers for HIE screening, or monitoring disease progression are limited. Herein, we sought to evaluate the clinical usefulness of plasma-type gelsolin (pGSN) and amyloid-beta (Aβ) 40 and 42 as prognostic biomarkers for HIE. pGSN has been previously suggested as a feasible marker in other brain injuries and amyloid-beta 40 and 42 are classically assessed in neurodegenerative diseases...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29450878/antepartum-risk-factors-for-moderate-to-severe-neonatal-hypoxic-ischemic-encephalopathy-a-swedish-national-cohort-study
#20
Lena Liljestrom, Anna-Karin Wikstrom, Johan Agren, Maria Jonsson
INTRODUCTION: Our aim was to identify antepartum risk factors for neonatal hypoxic ischemic encephalopathy, with a focus on maternal body mass index and height. MATERIAL AND METHODS: National population-based cohort study of 692 428 live-born infants ≥36 gestational weeks in Sweden, 2009-2015. Data from the Swedish Medical Birth Register and the Swedish Neonatal Quality Register were linked. Short maternal stature was defined as ≤155 cm, and overweight as body mass index ≥25 kg/m2 ...
February 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
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