scholarly journals A Neonate with Subcutaneous Fat Necrosis after Passive Cooling: Does Polycythemia Have an Effect?

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Erhan Calisici ◽  
Mehmet Yekta Oncel ◽  
Halil Degirmencioglu ◽  
Gonca Sandal ◽  
Fuat Emre Canpolat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Perinatal Asphyxia ◽  
Subcutaneous Fat ◽  
Whole Body ◽  
Passive Cooling ◽  
Inflammatory Disorder ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Body Cooling ◽  
Whole Body Cooling

Subcutaneous fat necrosis (SCFN) is an inflammatory disorder of adipose tissue. The main risk factors for the development of SCFN are perinatal asphyxia and hypothermia. Presented here is a case of a newborn who developed SCFN in association with polycythemia and hypocalcemia following treatment by passive cooling. Neonates who undergo passive or whole body cooling therapy should be closely monitored for any signs of SCFN.

Subcutaneous Fat Necrosis as a Complication of Whole-Body Cooling for Birth Asphyxia

2010 ◽  
Vol 146 (8) ◽  
Author(s):  
Vikash Oza ◽  
James Treat ◽  
Noah Cook ◽  
Michael T. Tetzlaff ◽  
Albert Yan
Keyword(s):  
Subcutaneous Fat ◽  
Birth Asphyxia ◽  
Whole Body ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Body Cooling ◽  
Whole Body Cooling

Subcutaneous fat necrosis, a rare but serious side effect of hypoxic-ischemic encephalopathy and whole-body hypothermia

2019 ◽  
Vol 47 (9) ◽  
pp. 986-990 ◽  
Author(s):  
Mahdi Alsaleem ◽  
Lina Saadeh ◽  
Valerie Elberson ◽  
Vasantha H.S. Kumar
Keyword(s):  
Therapeutic Hypothermia ◽  
Subcutaneous Fat ◽  
Whole Body ◽  
Subcutaneous Fat Necrosis ◽  
P Values ◽  
Life Threatening ◽  
The Mean ◽  
Body Cooling ◽  
Whole Body Cooling ◽  
Ischemic Encephalopathy

Abstract Objective To describe the clinical characteristics and risk factors in infants with subcutaneous fat necrosis (SFN) following therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE). Methods A case-control study was performed by a retrospective chart review of infants with moderate or severe HIE admitted to a level IV regional perinatal center and who underwent whole-body cooling. Results A total of 14 (8.1%) of 171 infants with moderate or severe HIE who underwent whole-body cooling developed SFN during hospitalization. There were more females [71% (10/14)] and large-for-gestational age (LGA) infants [28% (4/14)] in the SFN group vs. 36% females (57/157) and 8% LGA infants (13/157) in the group without SFN (P-values of 0.009 and 0.015, respectively). The mean lowest platelet count was lower 108 ± 55 109/L vs. 146 ± 62 109/L and the mean highest calcium level was higher 11.3 ± 2.5 vs. 10.6 ± 0.8 mg/dL in infants with SFN vs. infants without SFN, respectively (P-values of 0.0078 and 0.006, respectively). Distribution of skin lesions followed distinctive patterns representing the areas with direct contact with the cooling blanket. One infant developed severe, life-threatening hypercalcemia that required aggressive management, including diuretics, corticosteroids and bisphosphonates. Conclusion Although SFN is a rare complication of therapeutic hypothermia, it can be a life-threatening condition if complicated by severe hypercalcemia. Infants who undergo therapeutic hypothermia for HIE need regular skin examinations to evaluate for SFN. If SFN is identified, monitoring of serum calcium levels to prevent life-threatening hypercalcemia is recommended.

Subcutaneous fat necrosis (SCFN) secondary to therapeutic hypothermia with persistent leucocytosis in a neonate

2021 ◽  
Vol 6 (2) ◽  
pp. 01-04
Author(s):  
Sandhya Govindarajan
Keyword(s):  
Subcutaneous Fat ◽  
Whole Body ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Suspected Sepsis ◽  
Metabolic Complications ◽  
Cell Counts ◽  
First Case ◽  
Male Neonate ◽  
Whole Body Cooling

We report a term male neonate, born to consanguineous parents through a difficult labour who needed resuscitation at birth, followed by ventilation for respiratory distress. In view of suspected Hypoxic Ischemic Injury, he was started on whole body cooling for 72 hours. He was treated as suspected sepsis with 5 days of intravenous antibiotics. On day 6, he was noted to have hard, painless skin nodules of his back and left arm which was clinically diagnosed as subcutaneous fat necrosis. His serum calcium and phosphate levels remained normal throughout hospital stay. His full blood counts and bone profile were monitored regularly. During follow-up at 6 weeks, his white cell counts continued to be high with 69% lymphocytes. To our knowledge, this is the first case of SCFN of a neonate associated with persistent leucocytosis. Haematological and metabolic complications should be closely monitored in a neonate with subcutaneous fat necrosis.

A Case Study of Severe Hypercalcemia Secondary to Subcutaneous Fat Necrosis: A Diagnosis of Exclusion

2019 ◽  
Vol 38 (4) ◽  
pp. 236-241 ◽  
Author(s):  
Mary Whalen
Keyword(s):  
Tissue Injury ◽  
Rare Complication ◽  
Subcutaneous Fat ◽  
Ischemic Injury ◽  
The Body ◽  
Whole Body ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Severe Hypercalcemia

Subcutaneous fat necrosis (SCFN) is a rare complication, usually occurring in otherwise healthy full-term infants who have experienced some level of trauma that causes ischemic injury to adipose tissue. Tissue injury usually occurs in areas of the body that are exposed to excessive pressure as during delivery. Tissue injury has also been described secondary to therapeutic cooling. This case study presents an infant who received whole body cooling for hypoxic ischemic injury and later developed severe hypercalcemia at one month of age without the skin lesions consistent with SCFN. The differential diagnosis for hypercalcemia and how it relates to SCFN is presented, as well as clinical presentation, treatment, and prognosis.

scholarly journals Edward Osmund Royle Reynolds CBE. 3 February 1933—24 April 2017

2019 ◽  
Vol 68 ◽  
pp. 333-351
Author(s):  
Rodney P. A. Rivers
Keyword(s):  
Perinatal Asphyxia ◽  
Perinatal Period ◽  
First Century ◽  
Whole Body ◽  
Resonance Spectroscopy ◽  
Scientific Medicine ◽  
The United Kingdom ◽  
New Ideas ◽  
Body Cooling ◽  
Whole Body Cooling

Edward Osmund Royle Reynolds was the founding father of neonatal medicine in the United Kingdom and a major leader in the field worldwide; he was a key advisor to government for a decade. He was one of the first paediatricians to specialize in the care of the newborn. He brought to the field a new emphasis on scientific medicine and intellectual rigour with an adventurous investigative and collaborative spirit. Known as Os by his colleagues, he inspired a team of clinicians and scientists who contributed to major advances in our understanding of lung disease in preterm infants and of neurological insults arising in the perinatal period that have contributed to the markedly improved survival and developmental outcomes observed in the twenty-first century compared with those of the 1950s and 1960s. The whole-body cooling, now widely utilized in the management of perinatal asphyxia, owes its introduction to the ground-breaking research utilizing magnetic resonance spectroscopy in animal and newborn studies initiated by Os. His enthusiasm for new ideas was often in evidence as was the breadth of his interests, knowledge and support. His wider influence is his legacy of the reports to government in which he was involved and is seen today in the National Neonatal Audit Programme run by the Royal College of Paediatrics and Child Health since 2006.

Occult Massive Visceral Fat Necrosis Following Therapeutic Hypothermia for Neonatal Encephalopathy

2017 ◽  
Vol 21 (5) ◽  
pp. 502-506
Author(s):  
Salwa Khedr ◽  
Anna Piskorski ◽  
Adrienne R Bingham ◽  
Justin Goldstein ◽  
Abbot R Laptook ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Neurodevelopmental Outcome ◽  
Pulmonary Artery Hypertension ◽  
Whole Body ◽  
Common Side Effect ◽  
Close Monitoring ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis

Therapeutic hypothermia (head or whole-body cooling) improves survival and neurodevelopmental outcome in term newborns with moderate-to-severe encephalopathy. Hypothermia treatment is well tolerated; the most common side effect is thrombocytopenia. In about 1% of infants, focal subcutaneous fat necrosis has been reported. We describe a case of clinically unsuspected massive visceral fat necrosis in a term infant with Apgar score 0 at 1 min (“resuscitated apparently stillborn” infant) who was treated with therapeutic hypothermia for 72 h and expired on the 25th day of life following a neonatal course complicated by severe encephalopathy, pulmonary artery hypertension, persistent thrombocytopenia, hypoglycemia, and severe basal ganglia-thalamic abnormalities on magnetic resonance imaging. Postmortem examination revealed extensive visceral (brown) fat necrosis, involving thoracic, abdominal, and retroperitoneal adipose tissue, with distinctive sparing of the subcutaneous (white) fat. The fulminant—yet clinically occult—visceral fat necrosis seen in this case suggests that (lesser degrees of) fat necrosis may go unrecognized in hypoxic-ischemic newborns, especially in those treated with hypothermia, and underscores the importance of close monitoring of encephalopathic newborns both in the short and long terms for complications of fat necrosis (hypercalcemia and nephrocalcinosis).

scholarly journals Systemic effects of whole-body cooling to 35 °C, 33.5 °C, and 30 °C in a piglet model of perinatal asphyxia: implications for therapeutic hypothermia

2012 ◽  
Vol 71 (5) ◽  
pp. 573-582 ◽  
Author(s):  
Aron Kerenyi ◽  
Dorottya Kelen ◽  
Stuart D. Faulkner ◽  
Alan Bainbridge ◽  
Manigandan Chandrasekaran ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Perinatal Asphyxia ◽  
Whole Body ◽  
Systemic Effects ◽  
Body Cooling ◽  
Whole Body Cooling

Local skin injury as a complication of whole body cooling for perinatal asphyxia

2012 ◽  
Vol 98 (2) ◽  
pp. F150-F151 ◽  
Author(s):  
Gamze Demirel ◽  
Istemi Han Celik ◽  
Fuat Emre Canpolat ◽  
Serife Suna Oguz ◽  
Omer Erdeve ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Whole Body ◽  
Skin Injury ◽  
Local Skin ◽  
Body Cooling ◽  
Whole Body Cooling
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