scholarly journals To evaluate the role of MRI in infants with suspected hypoxic ischemic encephalopathy and prognosticating neurological outcome at end of one year

2017 ◽  
Vol 5 (5) ◽  
pp. 1893
Author(s):  
Shreyas Ramachandran ◽  
Smiti Sripathi
Keyword(s):  
Clinical Outcome ◽  
Motor Development ◽  
Perinatal Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurological Outcomes ◽  
Common Causes ◽  
One Year ◽  
Ischemic Encephalopathy

Background: Hypoxic ischemic encephalopathy (HIE) is one the common causes of neonatal fatality due to perinatal asphyxia. The long-term outcomes of HIE are impaired mental and motor development, hearing loss, recurrent seizures and cerebral palsy. MRI is increasingly becoming the gold standard in diagnosis of HIE as it involves no radiation and can be performed during a neonates physiological sleep. To evaluate the role of MRI in infants with suspected hypoxic ischemic encephalopathy in prognosticating neurological outcomes at end of one year.Methods: A total of 50 patients were included in the study who underwent MRI of brain. A clinical follow up was done at the end of one year.Results: The sensitivity of MRI in prognosticating clinical outcome was 72% and specificity was 71% while PPV and NPV was 86% and 50% respectively.Conclusions: MRI is a useful modality to assess early changes in HIE and it can prognosticate clinical outcome.

scholarly journals Prognostic role of acute kidney injury on long-term outcome in infants with hypoxic-ischemic encephalopathy

2019 ◽  
Vol 35 (3) ◽  
pp. 477-483 ◽  
Author(s):  
Francesco Cavallin ◽  
Giulia Rubin ◽  
Enrico Vidal ◽  
Elisa Cainelli ◽  
Luca Bonadies ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Prognostic Role ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ischemic Encephalopathy

scholarly journals Magnetic resonance imaging and spectroscopy in evaluation of hypoxic ischemic encephalopathy in pediatric age group

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Fatma Ibrahim Soliman Elshal ◽  
Walid Ahmed Elshehaby ◽  
Mahmoud Abd elaziz Dawoud ◽  
Ekhlas Abdelmonem Shaban
Keyword(s):  
White Matter ◽  
Basal Ganglia ◽  
Magnetic Resonance ◽  
Motor Development ◽  
Perinatal Asphyxia ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Spectroscopy ◽  
Significant Difference ◽  
Ischemic Encephalopathy

Abstract Background Hypoxic ischemic encephalopathy is a major cause of pediatric mortality and morbidity, with possible long-term neurologic sequel, such as cerebral palsy. With improvements in care of at-risk neonates, more children survive. This makes it increasingly important to assess, soon after birth, the prognosis of children with hypoxic-ischemic encephalopathy. The aim of the study was to assess the additive role of magnetic resonance spectroscopy over conventional MRI in diagnosis and early prediction of pathological motor development in neonates with hypoxic ischemic encephalopathy. Results MRS ratios showed significant difference between unfavorable and normal outcome infants. MRS ratios as Lac/Cr, NAA/Cr and NAA/Cho within basal ganglia, thalamus and white matter can significantly differentiate between patients with normal and pathological outcome at 1 year. Lac/Cr positively correlates with the severity of HIE. Both NAA/Cr and NAA/Cho negatively correlate with the severity of the disease. Ratios cutoff values as Lac/Cr above 0.38 and 0.42 in basal ganglia and white matter, respectively, NAA/Cr below 0.9 and 0.8 in basal ganglia and occipital white matter, respectively, and NAA/Cho below 0.29 and 0.31 in basal ganglia and frontal white matter, respectively, were significantly predictive of pathological outcome. Conclusion High Lac/Cr, low NAA/Cr and low NAA/Cho ratios within examined regions of the brain including deep grey matter nuclei as well as white matter are associated with an adverse outcome in infants with perinatal asphyxia. MRS is an accurate quantitative MR biomarker within the neonatal period for prediction of neurodevelopmental outcome after perinatal HIE. MRS may be useful in early clinical management decisions, and counseling parents thereby ensuring appropriate early intervention and rehabilitation.

scholarly journals Antioxidants in Hypoxic Ischemic Encephalopathy

2015 ◽  
Vol 34 (3) ◽  
pp. 171-174
Author(s):  
AVS Rathee ◽  
PL Prasad
Keyword(s):  
Free Radicals ◽  
Vitamin C ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Multiple Organ ◽  
The Other ◽  
Hypoxic Ischemic Encephalopathy ◽  
Not Given ◽  
Ischemic Encephalopathy

Introduction: Perinatal asphyxia and related injuries are leading cause of morbidity and mortality in India. These babies are at risk to develop hypoxic ischemic encephalopathy (HIE) due to multiple organ including brain damage. The role of malondialdehyde (MDA) as a marker of free radical injury has been well established. Vitamin C and alpha Tocopherols have neutralizing effects on the free radicals. Considering these facts, it was decided to estimate serum MDA level in cases of HIE and the neutralizing effects of Vitamin C and Vitamin E. Material and Methods: The study was conducted in a tertiary care teaching hospital. Neonates with an Apgar score of <6 at 5 minutes and birth weight >2500g were included in the study. They were randomized into two groups. One group was given Vit E and vitamin C and the other was not given any of the anti oxidants. Serum MDA level were measured in both groups. Result: Serum MDA level was found to be increasing in both groups, but the increase was significantly higher in group II where antioxidants were not given. It was also found that serum MDA level was significantly low in antioxidants groups with HIE than those without antioxidants. Conclusion: Antioxidants supplementation in cases of HIE is associated with lesser production of free radicals and their neutralization is affected by antioxidants resulting into lesser damage to brain. DOI: http://dx.doi.org/10.3126/jnps.v34i3.10122 J Nepal Paediatr Soc 2014;34(3):171-174.

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.

scholarly journals Scutellarin ameliorates neonatal hypoxic-ischemic encephalopathy associated with GAP43-dependent signaling pathway

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rui-Ze Niu ◽  
Liu-Lin Xiong ◽  
Hao-Li Zhou ◽  
Lu-Lu Xue ◽  
Qing-Jie Xia ◽  
...  
Keyword(s):  
Neuronal Death ◽  
Ischemic Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Qrt Pcr ◽  
Pharmacological Analysis ◽  
Ischemic Encephalopathy ◽  
Hypoxic Ischemic Injury

Abstract Background Neonatal hypoxic-ischemic encephalopathy (HIE) refers to the perinatal asphyxia caused by the cerebral hypoxic-ischemic injury. The current study was aimed at investigating the therapeutic efficacy of Scutellarin (Scu) administration on neurological impairments induced by hypoxic-ischemic injury and exploring the underlying mechanisms. Methods Primary cortical neurons were cultured and subjected to oxygen–glucose deprivation (OGD), and then treated with Scu administration. The growth status of neurons was observed by immunofluorescence staining of TUJ1 and TUNEL. Besides, the mRNA level of growth-associated protein 43 (GAP43) in OGD neurons with Scu treatment was detected by quantitative real-time polymerase chain reaction (qRT-PCR). To further verify the role of GAP43 in Scu treatment, GAP43 siRNA and knockout were applied in vitro and in vivo. Moreover, behavioral evaluations were performed to elucidate the function of GAP43 in the Scu-ameliorated long-term neurological impairments caused by HI insult. The underlying biological mechanism of Scu treatment was further elucidated via network pharmacological analysis. Finally, the interactive genes with GAP43 were identified by Gene MANIA and further validated by qRT-PCR. Results Our data demonstrated that Scu treatment increased the number of neurons and axon growth, and suppressed cell apoptosis in vitro. And the expression of GAP43 was downregulated after OGD, but reversed by Scu administration. Besides, GAP43 silencing aggravated the Scu-ameliorated neuronal death and axonal damage. Meanwhile, GAP43 knockout enlarged brain infarct area and deteriorated the cognitive and motor dysfunctions of HI rats. Further, network pharmacological analysis revealed the drug targets of Scu participated in such biological processes as neuronal death and regulation of neuronal death, and apoptosis-related pathways. GAP43 exhibited close relationship with PTN, JAK2 and STAT3, and GAP43 silencing upregulated the levels of PTN, JAK2 and STAT3. Conclusions Collectively, our findings revealed Scu treatment attenuated long-term neurological impairments after HI by suppressing neuronal death and enhancing neurite elongation through GAP43-dependent pathway. The crucial role of Scutellarin in neuroprotection provided a novel possible therapeutic agent for the treatment of neonatal HIE. Graphic abstract

scholarly journals Predictions of Hypoxic-Ischemic Encephalopathy by Umbilical Cord Blood Lactate in Newborns with Birth Asphyxia

2019 ◽  
Vol 7 (21) ◽  
pp. 3564-3567
Author(s):  
Ton Nu Van Anh ◽  
Tran Kiem Hao ◽  
Nguyen Thi Diem Chi ◽  
Nguyen Huu Son
Keyword(s):  
Cord Blood ◽  
Blood Lactate ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Predictors ◽  
Ischemic Encephalopathy

AIM: The aim of the study was to investigate the role of umbilical cord blood lactate as early predictors of hypoxic ischemic encephalopathy in newborns with perinatal asphyxia and to evaluate their sensitivity and specificity for the early identification of hypoxic ischemic encephalopathy infants. METHODS: We performed а descriptive cross sectionаl study between Аpril 2014 аnd Аpril 2015 аt Hue Central Hospital, Vietnаm. 41 аsphyxiа newborns (Apgar score ≤ 7) were included in the study. Umbilicаl cord blood is sаmpled for lаctаte аnаlysis. RESULTS: Umbilicаl cord blood lаctаte levels were significаntly higher аmong infаnts born with HIE (meаn 8.72 ± 1.75, rаnge 5.12 – 11.96) compаred to thаt with asphyxic infаnts without HIE (meаn 6.86 ± 1.33, rаnge 4.74 – 10.30), p = 0.00. With the optimаl cutoff point for umbilicаl cord blood lаctаte level of 8.12 mmol/l to susspected of HIE (аreа under the curve 0.799) hаd а sensitivity 73.7% (95% CI: 48.8-90.9), specificity 86.4% (95% CI: 65.1-97.1). CONCLUSION: Umbilical cord blood lactate could be used as early predictors in diagnosis of hypoxic ischemic encephalopathy in newborns with asphyxia.

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