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HIE

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https://www.readbyqxmd.com/read/29747886/therapeutic-hypothermia-how-can-we-optimize-this-therapy-to-further-improve-outcomes
#1
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/29514165/high-dose-erythropoietin-for-asphyxia-and-encephalopathy-heal-a-randomized-controlled-trial-background-aims-and-study-protocol
#2
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/29433475/benefits-of-starting-hypothermia-treatment-within-6-h-vs-6-12-h-in-newborns-with-moderate-neonatal-hypoxic-ischemic-encephalopathy
#3
Wen Jia, Xiaoping Lei, Wenbin Dong, Qingping Li
BACKGROUND: It has been suggested that mild hypothermia treatment of hypoxia-ischemic encephalopathy (HIE) should start within 6 h after HIE, but many children are admitted to the hospital > 6 h, particularly in developing areas. We aimed to determine whether hypothermia treatment could remain effective within 12 h after birth. METHODS: According to their admission, 152 newborns were enrolled in the < 6 h and 6-12 h after HIE groups. All newborns received conventional treatment combined with mild head hypothermia therapy, according to our routine clinical practice...
February 12, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29466806/vitamin-d-and-its-role-in-neonatal-hypoxic-ischemic-brain-injury
#4
Lyndsey E Stessman, Eric S Peeples
Emerging evidence has demonstrated that vitamin D plays an important role in many adult neurologic disorders, but is also critical in neuronal development and pruning in the neonatal and pediatric populations. Neonates are at a particularly high risk of vitamin D deficiency, in part due to the high prevalence of maternal deficiency during pregnancy. Several preclinical studies have demonstrated that infants born to vitamin D-deficient mothers are at a high risk of developing neonatal brain injury, and recent clinical studies have shown that neonates with hypoxic-ischemic encephalopathy (HIE) tend to be vitamin D-deficient...
February 21, 2018: Neonatology
https://www.readbyqxmd.com/read/29472139/amplitude-integrated-electroencephalography-for-seizure-detection-in-newborn-infants
#5
REVIEW
Lena Hellström-Westas
The amplitude-integrated electroencephalogram (aEEG) is a filtered and compressed EEG trend that can be used for long-term monitoring of brain function in patients of all ages. aEEG is increasingly used in neonatal intensive care units since several studies have shown its utility in high-risk newborn infants. Main indications for aEEG monitoring include early evaluation of brain function after perinatal asphyxia and seizure detection. The aEEG is usually recorded from one or two channels derived from parietal, central, or frontal leads...
February 13, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29326708/high-amounts-of-s100-alarmins-confer-antimicrobial-activity-on-human-breast-milk-targeting-pathogens-relevant-in-neonatal-sepsis
#6
Sabine Pirr, Manuela Richter, Beate Fehlhaber, Julia Pagel, Christoph Härtel, Johannes Roth, Thomas Vogl, Dorothee Viemann
Sepsis is a leading cause of perinatal mortality worldwide. Breast milk (BM) feeding is protective against neonatal sepsis, but the molecular mechanisms remain unexplained. Despite various supplementations with potential bioactive components from BM formula feeding cannot protect from sepsis. S100-alarmins are important immunoregulators in newborns preventing excessive inflammation. At high concentrations, the S100A8/A9 protein complex also has antimicrobial properties due to its metal ion chelation capacity...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/26482675/treating-eeg-seizures-in-hypoxic-ischemic-encephalopathy-a-randomized-controlled-trial
#7
RANDOMIZED CONTROLLED TRIAL
Preethi Srinivasakumar, John Zempel, Shamik Trivedi, Michael Wallendorf, Rakesh Rao, Barbara Smith, Terrie Inder, Amit M Mathur
BACKGROUND: The impact of treating electrographic seizures in hypoxic ischemic encephalopathy (HIE) is unknown. METHODS: Neonates ≥36 weeks with moderate or severe HIE were randomly assigned to either treatment of electrographic seizures alone (ESG) or treatment of clinical seizures (CSG). Conventional EEG video was monitored in both groups for up to 96 hours. Cumulative electrographic seizure burden (SB) was calculated in seconds and converted to log units for analysis...
November 2015: Pediatrics
https://www.readbyqxmd.com/read/29114743/mild-neonatal-encephalopathy-how-when-and-how-much-to-treat
#8
Gregory A Lodygensky, Malcolm R Battin, Alistair J Gunn
No abstract text is available yet for this article.
January 1, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29067428/effect-of-therapeutic-hypothermia-initiated-after-6-hours-of-age-on-death-or-disability-among-newborns-with-hypoxic-ischemic-encephalopathy-a-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Abbot R Laptook, Seetha Shankaran, Jon E Tyson, Breda Munoz, Edward F Bell, Ronald N Goldberg, Nehal A Parikh, Namasivayam Ambalavanan, Claudia Pedroza, Athina Pappas, Abhik Das, Aasma S Chaudhary, Richard A Ehrenkranz, Angelita M Hensman, Krisa P Van Meurs, Lina F Chalak, Amir M Khan, Shannon E G Hamrick, Gregory M Sokol, Michele C Walsh, Brenda B Poindexter, Roger G Faix, Kristi L Watterberg, Ivan D Frantz, Ronnie Guillet, Uday Devaskar, William E Truog, Valerie Y Chock, Myra H Wyckoff, Elisabeth C McGowan, David P Carlton, Heidi M Harmon, Jane E Brumbaugh, C Michael Cotten, Pablo J Sánchez, Anna Maria Hibbs, Rosemary D Higgins
Importance: Hypothermia initiated at less than 6 hours after birth reduces death or disability for infants with hypoxic-ischemic encephalopathy at 36 weeks' or later gestation. To our knowledge, hypothermia trials have not been performed in infants presenting after 6 hours. Objective: To estimate the probability that hypothermia initiated at 6 to 24 hours after birth reduces the risk of death or disability at 18 months among infants with hypoxic-ischemic encephalopathy...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28847350/the-use-of-whole-body-cooling-in-the-treatment-of-hypoxic-ischemic-encephalopathy
#10
REVIEW
Tiffany Harriman, Wanda T Bradshaw, Stephanie M Blake
Hypoxic-ischemic encephalopathy (HIE) is a major cause of morbidity and mortality in neonates. Hypoxic-ischemic encephalopathy occurs as a result of a perinatal hypoxic-ischemic event just prior to or during delivery. Therapeutic hypothermia using whole body cooling is the current treatment of choice to reduce brain injury and improve long-term neurodevelopmental outcomes for neonates with HIE. All English language articles published since 2005 in PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were analyzed for existing evidence-based methods for whole body cooling...
September 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28942433/therapeutic-hypothermia-in-mild-neonatal-encephalopathy-a-national-survey-of-practice-in-the-uk
#11
Vânia Oliveira, Dev Prya Singhvi, Paolo Montaldo, Peter J Lally, Josephine Mendoza, Swati Manerkar, Seetha Shankaran, Sudhin Thayyil
Although major cooling trials (and subsequent guidelines) excluded babies with mild encephalopathy, anecdotal evidence suggests that cooling is often offered to these infants. We report a national survey on current cooling practices for babies with mild encephalopathy in the UK. From 74 neonatal units contacted, 68 were cooling centres. We received 54 responses (79%) and included 48 (five excluded due to incomplete data and one found later not to offer cooling). Of these, 36 centres (75%) offered cooling to infants with mild encephalopathy...
September 23, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28814548/chorioamnionitis-in-the-development-of-cerebral-palsy-a-meta-analysis-and-systematic-review
#12
REVIEW
Zhongjie Shi, Lin Ma, Kehuan Luo, Monika Bajaj, Sanjay Chawla, Girija Natarajan, Henrik Hagberg, Sidhartha Tan
CONTEXT: Chorioamnionitis (CA) has often been linked etiologically to cerebral palsy (CP). OBJECTIVES: To differentiate association from risk of CA in the development of CP. DATA SOURCES: PubMed, Cochrane Library, Embase, and bibliographies of original studies were searched by using the keywords (chorioamnionitis) AND ((cerebral palsy) OR brain). STUDY SELECTION: Included studies had to have: (1) controls, (2) criteria for diagnoses, and (3) neurologic follow-up...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/28780500/perinatal-risk-factors-for-neonatal-encephalopathy-an-unmatched-case-control-study
#13
Cally J Tann, Margaret Nakakeeto, Barbara A Willey, Margaret Sewegaba, Emily L Webb, Ibby Oke, Emmanuel Derek Mutuuza, Donald Peebles, Margaret Musoke, Kathryn A Harris, Neil J Sebire, Nigel Klein, Jennifer J Kurinczuk, Alison M Elliott, Nicola J Robertson
OBJECTIVE: Neonatal encephalopathy (NE) is the third leading cause of child mortality. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. This study examined perinatal risks factor for NE in Uganda. DESIGN: Unmatched case-control study. SETTING: Mulago National Referral Hospital, Kampala, Uganda. METHODS: 210 term infants with NE and 409 unaffected term infants as controls were recruited over 13 months...
May 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28786098/antenatal-and-intrapartum-interventions-for-preventing-cerebral-palsy-an-overview-of-cochrane-systematic-reviews
#14
REVIEW
Emily Shepherd, Rehana A Salam, Philippa Middleton, Maria Makrides, Sarah McIntyre, Nadia Badawi, Caroline A Crowther
BACKGROUND: Cerebral palsy is an umbrella term encompassing disorders of movement and posture, attributed to non-progressive disturbances occurring in the developing fetal or infant brain. As there are diverse risk factors and causes, no one strategy will prevent all cerebral palsy. Therefore, there is a need to systematically consider all potentially relevant interventions for their contribution to prevention. OBJECTIVES: To summarise the evidence from Cochrane reviews regarding the effects of antenatal and intrapartum interventions for preventing cerebral palsy...
August 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#15
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
December 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28225884/clinical-hypoxic-ischemic-encephalopathy-score-of-the-iberoamerican-society-of-neonatology-siben-a-new-proposal-for-diagnosis-and-management
#16
José Maria Rodriguez Perez, Sergio G Golombek, Augusto Sola
Hypoxic ischemic encephalopathy is a major complication of perinatal asphyxia, with high morbidity, mortality and neurologic sequelae as cerebral palsy, mostly in poor or developing countries. The difficulty in the diagnosis and management of newborns in these countries is astonishing, thus resulting in unreliable data on this pathology and bad outcomes regarding mortality and incidence of neurologic sequelae. The objective of this article is to present a new clinical diagnostic score to be started in the delivery room and to guide the therapeutic approach, in order to improve these results...
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28351039/prognostic-value-of-the-apparent-diffusion-coefficient-in-newborns-with-hypoxic-ischaemic-encephalopathy-treated-with-therapeutic-hypothermia
#17
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...
2017: Neonatology
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#18
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
July 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28142140/dha-reduces-oxidative-stress-after-perinatal-asphyxia-a-study-in-newborn-piglets
#19
Rønnaug Solberg, Mariangela Longini, Fabrizio Proietti, Serafina Perrone, Cosetta Felici, Alessio Porta, Ola Didrik Saugstad, Giuseppe Buonocore
BACKGROUND: Perinatal hypoxic-ischemic brain damage is a major cause of acute mortality and chronic neurological morbidity in infants and children. Oxidative stress due to free radical formation and the initiation of abnormal oxidative reactions appears to play a key role. Docosahexanoic acid (DHA), a main component of brain membrane phospholipids, may act as a neuroprotectant after hypoxia-ischemia by regulating multiple molecular pathways and gene expression. OBJECTIVES: The aims of this study were to test the hypothesis that DHA provides significant protection against lipoperoxidation damage in the cerebral cortex and hippocampus in a neonatal piglet model of severe hypoxia-reoxygenation...
2017: Neonatology
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
#20
COMPARATIVE STUDY
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...
April 2017: Journal of Pediatrics
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