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therapeutic hypothermia in neonates

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https://www.readbyqxmd.com/read/27863707/outcomes-in-childhood-following-therapeutic-hypothermia-for-neonatal-hypoxic-ischemic-encephalopathy-hie
#1
REVIEW
Girija Natarajan, Athina Pappas, Seetha Shankaran
In this article, we review the childhood outcomes of neonates with birth depression and/or hypoxic-ischemic encephalopathy. The outcomes of these children prior to the era of hypothermia for neuroprotection will first be summarized, followed by discussion of results from randomized controlled trials of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy. The predictors of outcome in childhood following neonatal HIE using clinical and imaging biomarkers following hypothermia therapy will be described...
November 15, 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27855152/heart-rate-variability-in-hypoxic-ischemic-encephalopathy-during-therapeutic-hypothermia
#2
Robert M Goulding, Nathan J Stevenson, Deirdre M Murray, Vicki Livingstone, Peter M Filan, Geraldine B Boylan
BACKGROUND: Therapeutic hypothermia (TH) aims to ameliorate further injury in infants with moderate and severe hypoxic ischemic encephalopathy (HIE). We aim to assess the effect of TH on heart rate variability (HRV) in infants with HIE. METHODS: Multi-channel video-electroencephalography (EEG) and electrocardiography were assessed at 6-72h after birth in full-term infants with HIE, recruited prior to (pre-TH group) and following (TH group) the introduction of TH in our neonatal unit...
November 17, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27844484/golden-60%C3%A2-minutes-of-newborn-s-life-part-2-term-neonate
#3
Deepak Sharma, Pradeep Sharma, Sweta Shastri
The concept of "Golden 60 minutes" or "Golden Hour" has been derived from adult trauma. It has been defined as the first 60 minutes of postnatal life. It has been seen that care received by any newborn in the initial first hour have implications in the future life, showing the importance of golden hour. The major cause of neonatal mortality term newborn is asphyxia, which can be reduced with effective resuscitation. In golden hour approach for term newborn, the importance is given to effective and evidence based resuscitation, post-resuscitation care, delayed cord clamping, prevention of hypothermia, immediate breast feeding, prevention of hypoglycemia, and starting of therapeutic hypothermia in case of moderate to severe asphyxia...
November 15, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27834742/results-of-the-ictus-2-trial-intravascular-cooling-in-the-treatment-of-stroke-2
#4
Patrick Lyden, Thomas Hemmen, James Grotta, Karen Rapp, Karin Ernstrom, Teresa Rzesiewicz, Stephanie Parker, Mauricio Concha, Syed Hussain, Sachin Agarwal, Brett Meyer, Julie Jurf, Irfan Altafullah, Rema Raman
BACKGROUND AND PURPOSE: Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients. METHODS: Safety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27830959/neonatal-hypoxic-ischemic-encephalopathy-an-update-on-disease-pathogenesis-and-treatment
#5
Edibe Pembegül Yıldız, Barış Ekici, Burak Tatlı
Hypoxic ischemic encephalopathy (HIE) is the most important reason for morbidity and mortality in term-born infants. Understanding pathophysiology of the brain damage is essential for the early detection of patients with high risk for HIE and development of strategies for their treatments. Areas covered: This review discusses pathophysiology of the neonatal HIE and its treatment options, including hypothermia, melatonin, allopurinol, topiramate, erythropoietin, N-acetylcyctein, magnesium sulphate and xenon...
November 10, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27823842/cerebral-sinovenous-thrombosis-in-the-asphyxiated-cooled-infants-a-prospective-observational-study
#6
Maurizio Radicioni, Vittorio Bini, Pietro Chiarini, Ambra Fantauzzi, Francesca Leone, Raffaella Scattoni, Pier Giorgio Camerini
BACKGROUND: Cerebral sinovenous thrombosis is unusual in the asphyxiated cooled infants, but reliable data regarding the incidence of this comorbidity are lacking. We assessed the incidence of sinovenous thrombosis in a population of asphyxiated cooled infants by performing routine brain magnetic resonance venography. METHODS: All asphyxiated infants who underwent therapeutic cooling at our institution completed brain magnetic resonance venography after rewarming...
October 6, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27802300/amplitude-integrated-electroencephalogram-as-a-prognostic-tool-in-neonates-with-hypoxic-ischemic-encephalopathy-a-systematic-review
#7
Ruth Del Río, Carlos Ochoa, Ana Alarcon, Juan Arnáez, Dorotea Blanco, Alfredo García-Alix
INTRODUCTION: Perinatal management and prognostic value of clinical evaluation and diagnostic tools have changed with the generalization of therapeutic hypothermia (TH) in infants with hypoxic-ischemic encephalopathy (HIE). AIM: to ascertain the prognostic value of amplitude integrated electroencephalogram (aEEG) in neonates with HIE considering hours of life and treatment with TH. METHODS: A systematic review was performed. Inclusion criteria were studies including data of neonates with HIE, treated or not with TH, monitored with aEEG and with neurodevelopmental follow-up of at least 12 months...
2016: PloS One
https://www.readbyqxmd.com/read/27759568/survey-of-neonatal-intensive-care-unit-nurse-attitudes-toward-therapeutic-hypothermia-treatment
#8
Alexa Craig, Christine James, Janelle Bainter, Francis L Lucas, Scott Evans, John Glazer, Donna Dowling
BACKGROUND: The traumatic experiences of parents of babies treated with therapeutic hypothermia (TH) have been described. No research has assessed neonatal intensive care unit (NICU) nurse experience in providing care to hypothermic babies and emotional support to their parents. PURPOSE: To assess NICU nurse attitudes to the provision of TH with respect to perceptions about baby pain/sedation, need for nurse and parent education, decision making about initiation of TH, and barriers to best care...
October 18, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27749457/treatment-effects-on-neonatal-eeg
#9
Rawad Obeid, Tammy N Tsuchida
Conventional EEG and amplitude-integrated electroencephalography are used in neonates to assess prognosis and significant changes in brain activity. Neuroactive medications and hypothermia can influence brain activity and therefore alter EEG interpretation. There are limited studies on the effect of these therapies on neonatal EEG background activity. Medication effects on the EEG or amplitude-integrated electroencephalography include increased interburst interval duration, voltage suppression, and sleep disruption...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27697314/an-emerging-adverse-outcome-of-therapeutic-hypothermia-in-neonates
#10
Asad Abbas, Khalid Mannan
No abstract text is available yet for this article.
December 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27685816/timing-of-therapeutic-hypothermia-for-inborn-and-outborn-infants-with-neonatal-encephalopathy
#11
L Reaney, V Livingstone, C Bogue, E M Dempsey, P M Filan
Therapeutic hypothermia is now the standard of care for infants with moderate to severe hypoxic ischaemic encephalopathy. Sixty-three infants received therapeutic hypothermia at Cork University Maternity Hospital (CUMH) from 2010-2014. Median gestational age was 40 weeks. Eighteen (29%) infants were Sarnat grade 3, 41(65%) grade 2 and 4(6%) grade 1. Nineteen outborn infants arrived in CUMH at a median (IQR) age of 310 (270, 420) minutes. Four (21%) outborn infants were within the target temperature range on arrival...
2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27676120/therapeutic-hypothermia-during-neonatal-transport-active-cooling-helps-reach-the-target
#12
Tiffany D Stafford, Joseph L Hagan, Curtis G Sitler, Caraciolo J Fernandes, Jeffrey R Kaiser
Perinatal hypoxic ischemic encephalopathy (HIE) can lead to severe neurodevelopmental outcome and death. Therapeutic hypothermia is neuroprotective for infants with moderate-to-severe HIE. However, therapeutic hypothermia is only offered at high-level regional neonatal intensive care units (NICUs), necessitating the need to transport sick infants to referral centers. The goal of this study was to evaluate whether active cooling on transport is more effective than passive cooling in achieving temperatures in the treatment target range (33°C-34°C) on arrival to the Texas Children's Hospital (TCH) NICU...
September 27, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27650049/early-eeg-grade-and-outcome-at-5-years-after-mild-neonatal-hypoxic-ischemic-encephalopathy
#13
Deirdre M Murray, Catherine M O'Connor, C Anthony Ryan, Irina Korotchikova, Geraldine B Boylan
OBJECTIVE: More than half of all infants with neonatal hypoxic ischemic encephalopathy (HIE) are graded as mild and do not meet current criteria for therapeutic hypothermia. These infants are often not enrolled in follow-up, and hence our knowledge of their long-term outcome is sparse. We wished to compare 5-year outcomes in a group of infants with mild, moderate, and severe HIE, graded with both early EEG and clinical assessment, none of whom were treated with therapeutic hypothermia...
September 20, 2016: Pediatrics
https://www.readbyqxmd.com/read/27647155/implementation-of-a-neurocritical-care-program-improved-seizure-detection-and-decreased-antiseizure-medication-at-discharge-in-neonates-with-hypoxic-ischemic-encephalopathy
#14
Rani Ameena Bashir, Liza Espinoza, Sakeer Vayalthrikkovil, Jeffrey Buchhalter, Leigh Irvine, Luis Bello-Espinosa, Khorshid Mohammad
BACKGROUND: We report the impact of implementing continuous video electroencephalography monitoring for neonates with hypoxic-ischemic encephalopathy via a protocol in the context of neonatal neuro-critical care program. METHODS: Neonates with hypoxic-ischemic encephalopathy were studied retrospectively two years before and after implementing continuous video electroencephalography for 72 hours as a care protocol. Before continuous video electroencephalography, a 60-minute routine electroencephalography was performed at the discretion of the provider...
August 3, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27623706/the-amikacin-research-program-a-stepwise-approach-to-validate-dosing-regimens-in-neonates
#15
Anne Smits, Aida Kulo, John van den Anker, Karel Allegaert
INTRODUCTION: For safe and effective use of antibacterial agents in neonates, specific knowledge on the pharmacokinetics (PK) and its covariates is needed. This necessitates a stepwise approach, including prospective validation. AREAS COVERED: We describe our approach throughout almost two decades to improve amikacin exposure in neonates. A dosing regimen has been developed and validated using pharmacometrics, considering current weight, postnatal age, perinatal asphyxia, and ibuprofen use...
September 21, 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27622966/effect-of-hypothermia-and-targeted-temperature-management-on-drug-disposition-and-response-following-cardiac-arrest-a-comprehensive-review-of-preclinical-and-clinical-investigations
#16
Kacey B Anderson, Samuel M Poloyac, Patrick M Kochanek, Philip E Empey
Targeted temperature management (TTM) has been shown to reduce mortality and improve neurological outcomes in out-of-hospital cardiac arrest (CA) patients and in neonates with hypoxic-ischemic encephalopathy (HIE). TTM has also been associated with adverse drug events in the critically ill patient due to its effect on drug pharmacokinetics (PKs) and pharmacodynamics (PDs). We aim to evaluate the current literature on the effect of TTM on drug PKs and PDs following CA. MEDLINE/PubMed databases were searched for publications, which include the MeSH terms hypothermia, drug metabolism, drug transport, P450, critical care, cardiac arrest, hypoxic-ischemic encephalopathy, pharmacokinetics, and pharmacodynamics between July 2006 and October 2015...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27622292/hypothermia-and-rewarming-activate-a-macroglial-unfolded-protein-response-independent-of-hypoxic-ischemic-brain-injury-in-neonatal-piglets
#17
Jennifer K Lee, Bing Wang, Michael Reyes, Jillian S Armstrong, Ewa Kulikowicz, Polan T Santos, Jeong-Hoo Lee, Raymond C Koehler, Lee J Martin
Therapeutic hypothermia provides incomplete neuroprotection after hypoxia-ischemia (HI)-induced brain injury in neonates. We previously showed that cortical neuron and white matter apoptosis are promoted by hypothermia and early rewarming in a piglet model of HI. The unfolded protein response (UPR) may be one of the potential mediators of this cell death. Here, neonatal piglets underwent HI or sham surgery followed by 29 h of normothermia, 2 h of normothermia + 27 h of hypothermia or 18 h of hypothermia + rewarming...
2016: Developmental Neuroscience
https://www.readbyqxmd.com/read/27616300/neuroprotective-effects-of-hypothermia-in-inflammatory-sensitized-hypoxic-ischemic-encephalopathy
#18
Mathilde Chevin, Clémence Guiraut, Caroline Maurice-Gelinas, Jessica Deslauriers, Sylvain Grignon, Guillaume Sébire
BACKGROUND: Despite the recent introduction of hypothermia as a mandatory standard of care, the incidence of neonatal encephalopathy in full-term newborns and its devastating neuro-behavioral outcomes continues to be a major individual, familial and social issue. Neonatal encephalopathy is mainly due to the compounding and interacting effects of hypoxia-ischemia and inflammation resulting from placental and other perinatal infections. It is unclear why hypothermia is effective in alleviating neonatal encephalopathy in some, but not all, full-term newborns...
September 9, 2016: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/27606053/perinatal-neuroprotection-update
#19
REVIEW
Angie C Jelin, Kirsten Salmeen, Dawn Gano, Irina Burd, Mari-Paule Thiet
Antepartum, intrapartum, and neonatal events can result in a spectrum of long-term neurological sequelae, including cerebral palsy, cognitive delay, schizophrenia, and autism spectrum disorders [1]. Advances in obstetrical and neonatal care have led to survival at earlier gestational ages and consequently increasing numbers of periviable infants who are at significant risk for long-term neurological deficits. Therefore, efforts to decrease and prevent cerebral insults attempt not only to decrease preterm delivery but also to improve neurological outcomes in infants delivered preterm...
2016: F1000Research
https://www.readbyqxmd.com/read/27583390/cytokine-changes-in-newborns-with-therapeutic-hypothermia-after-hypoxic-ischemic-encephalopathy
#20
C J Moon, Y A Youn, S K Yum, I K Sung
OBJECTIVE: This study aimed to examine changes in cytokines according to therapeutic hypothermia (TH) for newborn hypoxic ischemic encephalopathy (HIE). STUDY DESIGN: We studied 20 neonates who were admitted with a diagnosis of HIE in the neonatal intensive care unit. Cytokine concentration assay was carried out for neonates (n=12) who received TH and neonates (n=8) who were not treated with hypothermia by collecting blood sample at 12, 48 and 120 h after birth...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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