scholarly journals The myocardial function during and after whole-body therapeutic hypothermia for hypoxic–ischemic encephalopathy, a cohort study

2014 ◽  
Vol 90 (5) ◽  
pp. 247-252 ◽  
Author(s):  
Eirik Nestaas ◽  
Janne Helen Skranes ◽  
Asbjørn Støylen ◽  
Leif Brunvand ◽  
Drude Fugelseth
Keyword(s):  
Cohort Study ◽  
Therapeutic Hypothermia ◽  
Myocardial Function ◽  
Hypoxic Ischemic Encephalopathy ◽  
Whole Body ◽  
Ischemic Encephalopathy

scholarly journals A Successful Whole Body Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy During an ECMO Run in a Newborn

2019 ◽  
Vol 7 ◽  
Author(s):  
Emel Okulu ◽  
Omer Erdeve ◽  
Bahar Bingoler Pekcici ◽  
Tanil Kendirli ◽  
Zeynep Eyileten ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Whole Body ◽  
Ischemic Encephalopathy

scholarly journals Effects of Whole Body Therapeutic Hypothermia on Gastrointestinal Morbidity and Feeding Tolerance in Infants with Hypoxic Ischemic Encephalopathy

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Kimberly M. Thornton ◽  
Hongying Dai ◽  
Seth Septer ◽  
Joshua E. Petrikin
Keyword(s):  
Therapeutic Hypothermia ◽  
Median Time ◽  
Retrospective Cohort ◽  
Gastric Tube ◽  
Hypoxic Ischemic Encephalopathy ◽  
Tube Placement ◽  
Whole Body ◽  
Beneficial Effects ◽  
Ischemic Encephalopathy ◽  
Feeding Tolerance

Objective. This retrospective cohort study evaluated the effects of whole body therapeutic hypothermia (WBTH) on gastrointestinal (GI) morbidity and feeding tolerance in infants with moderate-to-severe hypoxic ischemic encephalopathy (HIE).Study Design. Infants ≥ 35 weeks gestational age and ≥1800 grams birth weight with moderate-to-severe HIE treated from 2000 to 2012 were compared. 68 patients had documented strictly defined criteria for WBTH: 32 historical control patients did not receive WBTH (non-WBTH) and 36 cohort patients received WBTH.Result. More of the non-WBTH group infants never initiated enteral feeds (28% versus 6%;P=0.02), never reached full enteral feeds (38% versus 6%,P=0.002), and never reached full oral feeds (56% versus 19%,P=0.002). Survival analyses demonstrated that the WBTH group reached full enteral feeds (median time: 11 versus 9 days;P=0.02) and full oral feeds (median time: 19 versus 10 days;P=0.01) sooner. The non-WBTH group had higher combined outcomes of death and gastric tube placement (47% versus 11%;P=0.001) and death and gavage feeds at discharge (44% versus 11%;P=0.005).Conclusion. WBTH may have beneficial effects on GI morbidity and feeding tolerance for infants with moderate-to-severe HIE.

scholarly journals Effects of therapeutic hypothermia on death among asphyxiated neonates with hypoxic-ischemic encephalopathy: A systematic review and meta-analysis of randomized control trials

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247229
Author(s):  
Biruk Beletew Abate ◽  
Melaku Bimerew ◽  
Bereket Gebremichael ◽  
Ayelign Mengesha Kassie ◽  
MesfinWudu Kassaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Therapeutic Hypothermia ◽  
Meta Analysis ◽  
Hypoxic Ischemic Encephalopathy ◽  
Whole Body ◽  
Randomized Control Trials ◽  
Risk Of Mortality ◽  
Randomized Control ◽  
Ischemic Encephalopathy

Background Hypoxic perinatal brain injury is caused by lack of oxygen to baby’s brain and can lead to death or permanent brain damage. However, the effectiveness of therapeutic hypothermia in birth asphyxiated infants with encephalopathy is uncertain. This systematic review and meta-analysis was aimed to estimate the pooled relative risk of mortality among birth asphyxiated neonates with hypoxic-ischemic encephalopathy in a global context. Methods We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search randomized control trials from electronic databases (PubMed, Cochrane library, Google Scholar, MEDLINE, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and meta register of Current Controlled Trials (mCRT)). The authors extracted the author’s name, year of publication, country, method of cooling, the severity of encephalopathy, the sample size in the hypothermic, and non-hypothermic groups, and the number of deaths in the intervention and control groups. A weighted inverse variance fixed-effects model was used to estimate the pooled relative risk of mortality. The subgroup analysis was done by economic classification of countries, methods of cooling, and cooling devices. Publication bias was assessed with a funnel plot and Eggers test. A sensitivity analysis was also done. Results A total of 28 randomized control trials with a total sample of 35, 92 (1832 hypothermic 1760 non-hypothermic) patients with hypoxic-ischemic encephalopathy were used for the analysis. The pooled relative risk of mortality after implementation of therapeutic hypothermia was found to be 0.74 (95%CI; 0.67, 0.80; I2 = 0.0%; p<0.996). The subgroup analysis revealed that the pooled relative risk of mortality in low, low middle, upper-middle and high income countries was 0.32 (95%CI; -0.95, 1.60; I2 = 0.0%; p<0.813), 0.5 (95%CI; 0.14, 0.86; I2 = 0.0%; p<0.998), 0.62 (95%CI; 0.41–0.83; I2 = 0.0%; p<0.634) and 0.76 (95%CI; 0.69–0.83; I2 = 0.0%; p<0.975) respectively. The relative risk of mortality was the same in selective head cooling and whole-body cooling method which was 0.74. Regarding the cooling device, the pooled relative risk of mortality is the same between the cooling cap and cooling blanket (0.74). However, it is slightly lower (0.73) in a cold gel pack. Conclusions Therapeutic hypothermia reduces the risk of death in neonates with moderate to severe hypoxic-ischemic encephalopathy. Both selective head cooling and whole-body cooling method are effective in reducing the mortality of infants with this condition. Moreover, low income countries benefit the most from the therapy. Therefore, health professionals should consider offering therapeutic hypothermia as part of routine clinical care to newborns with hypoxic-ischemic encephalopathy especially in low-income countries.

scholarly journals Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1193
Author(s):  
Yi-Fang Tu ◽  
Po-Ming Wu ◽  
Wen-Hao Yu ◽  
Chung-I Li ◽  
Cheng-Lin Wu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Therapeutic Hypothermia ◽  
Blood Lactate ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Perinatal Asphyxia ◽  
Adverse Outcomes ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurological Outcomes ◽  
Ischemic Encephalopathy

Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the most common cause of mortality and neurological disability in infancy after perinatal asphyxia. Reliable biomarkers to predict neurological outcomes of neonates after perinatal asphyxia are still not accessible in clinical practice. Methods: A prospective cohort study enrolled neonates with perinatal asphyxia. Biochemical blood tests and cerebral Doppler ultrasound were measured within 6 h of age and at the 4th day old. Neurological outcomes were assessed at 1 year old. Results: Sixty-four neonates with perinatal asphyxia were enrolled. Fifty-eight (90%) had hypoxic-ischemic encephalopathy (HIE) including 20 (34%) Stage I, 21 (36%) Stage II, and 17 (29%) Stage III. In the asphyxiated infants without therapeutic hypothermia, HIE stage, PH, and base excess levels within 6 h of age were the predictors of adverse outcomes. In the asphyxiated infants receiving therapeutic hypothermia, HIE stage failed to predict outcomes. Instead, blood lactate levels and pulsatility index (PI) of medial cerebral arteries (MCA) either in 6 h of age or at the 4th day old independently predicted adverse outcomes. Conclusions: Blood lactate, which is a common accessible test at the hospital and MCA PI on cerebral ultrasound could predict adverse outcomes in asphyxiated infants receiving therapeutic hypothermia.

Optimal Duration of Continuous Video-Electroencephalography in Term Infants With Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia

2017 ◽  
Vol 32 (6) ◽  
pp. 522-527 ◽  
Author(s):  
Naeem Mahfooz ◽  
Arie Weinstock ◽  
Bushra Afzal ◽  
Mariam Noor ◽  
David Vargas Lowy ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Diagnostic Yield ◽  
Hypoxic Ischemic Encephalopathy ◽  
Whole Body ◽  
Background Suppression ◽  
Term Infants ◽  
Resource Limited ◽  
Optimal Duration ◽  
Ischemic Encephalopathy ◽  
Video Eeg

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%). No new seizures were detected between 24-72 hours of therapeutic hypothermia. Background suppression was detected in 14 infants (40%) by 24 hours. In neonates with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia, continuous video-EEG has the highest diagnostic yield within the first 24 hours and during the rewarming phase. In the absence of prior seizures or antiepileptic therapy, limiting continuous video-EEG to these periods in resource-limited settings may reduce cost during therapeutic hypothermia.

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