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therapeutic hypothermia in neonates

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https://www.readbyqxmd.com/read/28351039/prognostic-value-of-the-apparent-diffusion-coefficient-in-newborns-with-hypoxic-ischaemic-encephalopathy-treated-with-therapeutic-hypothermia
#1
Eva-Marie Heursen, Amaya Zuazo Ojeda, Isabel Benavente Fernández, Gema Jimenez Gómez, Rosalía Campuzano Fernández-Colima, José Paz-Expósito, Simón Pedro Lubián López
BACKGROUND: Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia. OBJECTIVES: To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH). METHODS: This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH...
March 29, 2017: Neonatology
https://www.readbyqxmd.com/read/28288145/rectal-temperature-in-the-first-five-hours-after-hypoxia-ischaemia-critically-affects-neuropathological-outcomes-in-neonatal-rats
#2
Thomas Wood, Catherine Hobbs, Mari Falck, Anne Charlotte Brun, Else Marit Løberg, Marianne Thoresen
BACKGROUND: Hyperthermia after hypoxia-ischaemia (HI) in newborn infants is associated with worse neurological outcomes. Loss of thermoregulation may also be associated with greater injury. METHODS: In the postnatal-day 7 (P7) rat, the effect of 5h of graded hyperthermia (38°C or 39°C) immediately after unilateral HI was compared to normothermia (NT, 37°C), and therapeutic hypothermia (TH, 32°C). Early (negative geotaxis) and late (staircase test) behavioural testing was performed, as well as neuropathology scoring in adulthood...
March 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28282552/periictal-activity-in-cooled-asphyxiated-neonates-with-seizures
#3
Philippe Major, Anne Lortie, Mathieu Dehaes, Gregory Anton Lodygensky, Anne Gallagher, Lionel Carmant, Ala Birca
PURPOSE: Seizures are common in critically ill neonates. Both seizures and antiepileptic treatments may lead to short term complications and worsen the outcomes. Predicting the risks of seizure reoccurrence could enable individual treatment regimens and better outcomes. We aimed to identify EEG signatures of seizure reoccurrence by investigating periictal electrographic features and spectral power characteristics in hypothermic neonates with hypoxic-ischemic encephalopathy (HIE) with or without reoccurrence of seizures on rewarming...
March 2, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28273662/dedifferentiated-fat-cells-as-a-novel-source-for-cell-therapy-to-target-neonatal-hypoxic-ischemic-encephalopathy
#4
Alkisti Mikrogeorgiou, Yoshiaki Sato, Taiki Kondo, Tetsuo Hattori, Yuichiro Sugiyama, Miharu Ito, Akiko Saito, Keiko Nakanishi, Masahiro Tsuji, Tomohiko Kazama, Koichiro Kano, Taro Matsumoto, Masahiro Hayakawa
Neonatal hypoxic-ischemic (HI) encephalopathy (HIE) remains a major cause of mortality and persistent neurological disabilities in affected individuals. At present, hypothermia is considered to be the only applicable treatment option, although growing evidence suggests that cell-based therapy might achieve better outcomes. Dedifferentiated fat (DFAT) cells are derived from mature adipocytes via a dedifferentiation strategy called ceiling culture. Their abundance and ready availability might make them an ideal therapeutic tool for the treatment of HIE...
March 9, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28273115/therapeutic-hypothermia-increases-the-risk-of-cardiac-arrhythmia-for-perinatal-hypoxic-ischaemic-encephalopathy-a-meta-analysis
#5
Wei Zhang, Meizhu Lu, Chenlong Zhang, Ruwen Zhang, Xiaofeng Ou, Jianju Zhou, Yan Li, Yan Kang
OBJECTIVE: To determine whether therapeutic hypothermia after hypoxic ischaemic encephalopathy (HIE) in neonates increases the risk of cardiac arrhythmia during intervention. DESIGN: A meta-analysis was conducted using a fixed-effect model. Risk ratios, risk differences, and 95% confidence intervals, were measured. DATA SOURCES: Studies identified from the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Google Scholar, previous reviews, and abstracts from onset to August, 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28258592/neonatal-somatosensory-evoked-potentials-persist-during-hypothermia
#6
Päivi Nevalainen, Leena Lauronen, Marjo Metsäranta, Tuula Lönnqvist, Eero Ahtola, Sampsa Vanhatalo
AIM: Treatment with therapeutic hypothermia has challenged the use of amplitude-integrated electroencephalography in predicting outcomes after perinatal asphyxia. In this study, we assessed the feasibility and gain of somatosensory evoked potentials (SEP) during hypothermia. METHODS: This retrospective study comprised neonates from 35+6 to 42+2 gestational weeks and treated for asphyxia or hypoxic-ischaemic encephalopathy at Helsinki University Hospital between 14 February 2007 and 23 December 2009...
March 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28252661/predictive-value-of-amplitude-integrated-eeg-aeeg-after-rescue-hypothermic-neuroprotection-for-hypoxic-ischemic-encephalopathy-a-meta-analysis
#7
M Chandrasekaran, B Chaban, P Montaldo, S Thayyil
OBJECTIVE: Amplitude-integrated electroencephalography (aEEG) is a useful bedside tool in predicting the neurodevelopmental outcome after neonatal encephalopathy; however, the prognostic accuracy may be altered by rescue hypothermic neuroprotection. The objective of this study is to examine the prognostic accuracy of aEEG for predicting long-term neurodevelopmental outcomes in term newborn infants undergoing therapeutic hypothermia for neonatal encephalopathy. STUDY DESIGN: We examined all studies (Medline, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library; 2000 to 2014) comparing aEEG (6, 24, 48 or 72 h) in term encephalopathic babies undergoing therapeutic hypothermia, with neurodevelopmental outcome at 1 year or more...
March 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28217152/value-of-electroencephalographic-monitoring-in-newborns-with-hypoxic-ischemic-encephalopathy-treated-with-hypothermia
#8
Hatem Hamed Elshorbagy, Ahmed A Azab, Naglaa M Kamal, Naglaa Fathy Barseem, Mohamed M Bassiouny, Mostafa A Elsayed, Tohamy H Elkhouly
BACKGROUND: The values of electroencephalography (EEG) in neonatal hypoxic-ischemic encephalopathy (HIE) during therapeutic hypothermia (TH) are still uncertain. AIMS: The aim of this study is to detect EEG background, the prevalence of seizures during cooling, and to determine different EEG patterns that can predict brain injury in magnetic resonance imaging (MRI). PATIENTS AND METHODS: Thirty-nine newborns with HIE were subjected to TH. Continuous monitoring by video-EEG was carried out throughout cooling and during rewarming...
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28211647/clinical-characteristics-predicting-abnormal-brain-magnetic-resonance-image-findings-in-hypoxic-ischemic-encephalopathy-infants
#9
Sook K Yum, Cheong-Jun Moon, Young-Ah Youn, In K Sung
BACKGROUND: The aim of this study was to elucidate the specific clinical characteristics associated with abnormal brain magnetic resonance image(MRI) findings in hypoxic ischemic encephalopathy(HIE) infants in order to discern how to predict poorer outcomes more accurately. METHODS: A retrospective data analysis of HIE infants admitted to the neonatal intensive care unit of a tertiary hospital was performed. Baseline perinatal information and physical and neurological findings were compared in HIE infants according to the presence of abnormal brain MRI findings...
February 17, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28206999/early-eeg-power-predicts-mri-injury-in-infants-with-hypoxic-ischemic-encephalopathy
#10
S V Jain, J M Zempel, P Srinivasakumar, M Wallendorf, A Mathur
OBJECTIVE: Early identification of infants with hypoxic-ischemic encephalopathy who have adverse outcomes despite neuroprotection with therapeutic hypothermia (TH) is urgently needed. Recent studies have found limited value of amplitude integrated EEG (aEEG) for predicting short-term outcomes in this population. Other quantitative electroencephalography (EEG) variables reflecting EEG amplitude, such as EEG power, could provide early stratification of a high-risk cohort in this population...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28198757/effect-of-temperature-on-heart-rate-variability-in-neonatal-icu-patients-with-hypoxic-ischemic-encephalopathy
#11
An N Massaro, Heather E Campbell, Marina Metzler, Tareq Al-Shargabi, Yunfei Wang, Adre du Plessis, Rathinaswamy B Govindan
OBJECTIVE: To determine whether measures of heart rate variability are related to changes in temperature during rewarming after therapeutic hypothermia for hypoxic-ischemic encephalopathy. DESIGN: Prospective observational study. SETTING: Level 4 neonatal ICU in a free-standing academic children's hospital. PATIENTS: Forty-four infants with moderate to severe hypoxic-ischemic encephalopathy treated with therapeutic hypothermia...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28196356/therapeutic-hypothermia-provides-variable-protection-against-behavioral-deficits-after-neonatal-hypoxia-ischemia-a-potential-role-for-brain-derived-neurotrophic-factor
#12
Johana Diaz, Suleiman Abiola, Nancy Kim, Oliver Avaritt, Debra Flock, Jenny Yu, Frances J Northington, Raul Chavez-Valdez
BACKGROUND: Despite treatment with therapeutic hypothermia (TH), infants who survive hypoxic ischemic (HI) encephalopathy (HIE) have persistent neurological abnormalities at school age. Protection by TH against HI brain injury is variable in both humans and animal models. Our current preclinical model of hypoxia-ischemia (HI) and TH displays this variability of outcomes in neuropathological and neuroimaging end points with some sexual dimorphism. The detailed behavioral phenotype of this model is unknown...
February 15, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28193115/characterization-of-death-in-neonatal-encephalopathy-in-the-hypothermia-era
#13
Monica E Lemmon, Renee D Boss, Sonia L Bonifacio, Audrey Foster-Barber, A James Barkovich, Hannah C Glass
This study aimed to characterize the circumstances of death in encephalopathic neonates treated with therapeutic hypothermia. Patients who died after or during treatment with therapeutic hypothermia between 2007-2014 were identified. Patient circumstance of death was characterized using an established paradigm. Thirty-one of 229 patients died (14%) at a median of 3 days of life. Most who died were severely encephalopathic on examination (90%) and had severely abnormal electroencephalographic (EEG) findings (87%)...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28141793/sex-specific-associations-between-cerebrovascular-blood-pressure-autoregulation-and-cardiopulmonary-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#14
Raul Chavez-Valdez, Matthew O'Connor, Jamie Perin, Michael Reyes, Jillian Armstrong, Charlamaine Parkinson, Maureen Gilmore, Jacky Jennings, Frances J Northington, Jennifer K Lee
BACKGROUND: Cardiopulmonary injury is common in neonatal encephalopathy, but the link with cerebrovascular dysfunction is unknown. We hypothesized that cerebral autoregulation is associated with cardiopulmonary injury in neonates treated with therapeutic hypothermia (TH) for neonatal encephalopathy. METHODS: The cerebral hemoglobin volume index (HVx) from near-infrared spectroscopy was used to identify the mean arterial blood pressure (MAP) with optimal autoregulatory vasoreactivity (MAPOPT)...
January 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28141600/preventing-pressure-injuries-in-neonates-undergoing-therapeutic-hypothermia-for-hypoxic-ischemic-encephalopathy-an-interprofessional-quality-improvement-project
#15
Alexandra Luton, Jae Hernandez, Clive Robert Patterson, Jill Nielsen-Farrell, Anita Thompson, Jeffrey R Kaiser
BACKGROUND: Hospital-acquired pressure injuries (HAPIs) can be caused by multiple factors including pressure, shear, friction, moisture/incontinence, device-related pressure, immobility, inactivity, and nutritional deficits. Along with immobility, medical device-related (MDR) HAPIs are a primary cause of pressure injury in neonates, as the clinical practice setting has become increasingly technologically advanced. It is estimated that up to 50% of HAPIs are MDR in pediatric patients. Neonates are at particular risk for HAPI because of their specific anatomical, physiological, and developmental vulnerabilities...
January 30, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28112011/optimal-duration-of-continuous-video-electroencephalography-in-term-infants-with-hypoxic-ischemic-encephalopathy-and-therapeutic-hypothermia
#16
Naeem Mahfooz, Arie Weinstock, Bushra Afzal, Mariam Noor, David Vargas Lowy, Osman Farooq, Sarah G Finnegan, Satyan Lakshminrusimha
Continuous video-electroencephalography (EEG) is an important diagnostic and prognostic tool in newborns with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia. The optimal duration of continuous video-EEG during whole-body hypothermia is not known. We conducted a retrospective study of 35 neonates with hypoxic-ischemic encephalopathy undergoing whole-body hypothermia with continuous video-EEG. EEG ictal changes were detected in 9/35 infants (26%). Of these 9 infants, the seizures were initially observed within 30 minutes of EEG monitoring in 6 (67%), within 24 hours in 2 (22%), and during rewarming in 1 infant (11%)...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28091756/-recommendation-on-temperature-management-after-cardiopulmonary-arrest-and-severe-traumatic-brain-injury-in-childhood-beyond-the-neonatal-period-statement-of-the-german-society-for-neonatology-and-pediatric-intensive-care-medicine%C3%A2-gnpi-and-the-scientific-working
#17
S Brenner, C Eich, G Rellensmann, M U Schuhmann, T Nicolai, F Hoffmann
The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28081533/eeg-monitoring-technique-influences-the-management-of-hypoxic-ischemic-seizures-in-neonates-undergoing-therapeutic-hypothermia
#18
Saber Jan, Frances J Northington, Charlamaine M Parkinson, Carl E Stafstrom
Electroencephalogram (EEG) monitoring techniques for neonatal hypoxia-ischemia (HI) are evolving over time, and the specific type of EEG utilized could influence seizure diagnosis and management. We examined whether the type of EEG performed affected seizure treatment decisions (e.g., the choice and number of antiseizure drugs [ASDs]) in therapeutic hypothermia-treated neonates with HI from 2007 to 2015 in the Johns Hopkins Hospital Neonatal Intensive Care Unit. During this period, 3 different EEG monitoring protocols were utilized: Period 1 (2007-2009), single, brief conventional EEG (1 h duration) at a variable time during therapeutic hypothermia treatment, i...
January 17, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28062149/prediction-of-neonatal-seizures-in-hypoxic-ischemic-encephalopathy-using-electroencephalograph-power-analyses
#19
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...
February 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28051172/therapeutic-hypothermia-for-neonatal-encephalopathy-a-report-from-the-first-3-years-of-the-baby-cooling-registry-of-japan
#20
Kennosuke Tsuda, Takeo Mukai, Sachiko Iwata, Jun Shibasaki, Takuya Tokuhisa, Tomoaki Ioroi, Hiroyuki Sano, Nanae Yutaka, Akihito Takahashi, Akihito Takeuchi, Toshiki Takenouchi, Yuko Araki, Hisanori Sobajima, Masanori Tamura, Shigeharu Hosono, Makoto Nabetani, Osuke Iwata
Therapeutic hypothermia is recommended for moderate and severe neonatal encephalopathy, but is being applied to a wider range of neonates than originally envisaged. To examine the clinical use of therapeutic hypothermia, data collected during the first 3 years (2012-2014) of the Baby Cooling Registry of Japan were analysed. Of 485 cooled neonates, 96.5% were ≥36 weeks gestation and 99.4% weighed ≥1,800 g. Severe acidosis (pH < 7 or base deficit ≥16 mmol/L) was present in 68.9%, and 96.7% required resuscitation for >10 min...
January 4, 2017: Scientific Reports
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