THERAPEUTIC HYPOTHERMIA FOR HYPOXIC-ISCHEMIC ENCEPHALOPATHY: NEURODEVELOPMENTAL OUTCOME AT POSTNATAL 18 AND 36 MONTHS

2016 ◽  
Author(s):  
Ozgur OLUKMAN
Keyword(s):  
Therapeutic Hypothermia ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Ischemic Encephalopathy

scholarly journals Mammillary body atrophy and other MRI correlates of school-age outcome following neonatal hypoxic-ischemic encephalopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kim V. Annink ◽  
Linda S. de Vries ◽  
Floris Groenendaal ◽  
Rian M. J. C. Eijsermans ◽  
Manouk Mocking ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Memory Function ◽  
Neurodevelopmental Outcome ◽  
Standard Of Care ◽  
Hypoxic Ischemic Encephalopathy ◽  
School Age ◽  
Brain Volumes ◽  
Mammillary Bodies ◽  
Memory Problems ◽  
Ischemic Encephalopathy

AbstractThe mammillary bodies (MB) and hippocampi are important for memory function and are often affected following neonatal hypoxic ischemic encephalopathy (HIE). The aim of this study was to assess neurodevelopmental outcome in 10-year-old children with HIE with and without therapeutic hypothermia. Additional aims were to assess the associations between MB atrophy, brain volumes (including the hippocampi), white matter microstructure and neurodevelopmental outcome at school-age. Ten-year-old children with HIE were included, who were treated with therapeutic hypothermia (n = 22) or would have qualified but were born before this became standard of care (n = 28). Children completed a neuropsychological and motor assessment and MRI. Mammillary bodies were scored as normal or atrophic at 10 years. Brain volumes were segmented on childhood MRI and DTI scans were analysed using tract-based spatial statistics. Children with HIE suffered from neurocognitive and memory problems at school-age, irrespective of hypothermia. Hippocampal volumes and MB atrophy were associated with total and performance IQ, processing speed and episodic memory in both groups. Normal MB and larger hippocampi were positively associated with global fractional anisotropy. In conclusion, injury to the MB and hippocampi was associated with neurocognition and memory at school-age in HIE and might be an early biomarker for neurocognitive and memory problems.

Predictors of Long-Term Neurodevelopmental Outcome of Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia

2020 ◽  
Vol 40 (03) ◽  
pp. 322-334
Author(s):  
Ipsita Goswami ◽  
Mireille Guillot ◽  
Emily W. Y. Tam
Keyword(s):  
Brain Injury ◽  
Therapeutic Hypothermia ◽  
Prognostic Markers ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Secondary Brain Injury ◽  
Prognostic Utility ◽  
Initial Injury ◽  
Ischemic Encephalopathy

AbstractHypoxic-ischemic encephalopathy (HIE) is a manifestation of perinatal asphyxial insult that continues to evolve over days to weeks following the initial injury. Therapeutic hypothermia has demonstrated that a proportion of this secondary brain injury may indeed be preventable. However, therapeutic hypothermia has also altered the prognostic utility of many bedside tools that are commonly used as predictors of long-term neurodevelopmental outcome in HIE. Clinicians are often confronted with uncertainty when assessing the prognosis of infants with HIE. Improved understanding of the implications and limitations of individual investigations may inform clinical decisions and allow for timely intervention. This review summarizes the predictive value of currently available prognostic markers in HIE infants in the therapeutic hypothermia era, including clinical, biochemical, neurophysiological, physiological, and neuroimaging predictors.

scholarly journals Seizure burden and neurodevelopmental outcome in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia: A single center observational study

Seizure ◽  
2020 ◽  
Vol 83 ◽  
pp. 154-159
Author(s):  
Claudia Basti ◽  
Eugenia Maranella ◽  
Nicola Cimini ◽  
Alessia Catalucci ◽  
Simona Ciccarelli ◽  
...  
Keyword(s):  
Observational Study ◽  
Therapeutic Hypothermia ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Single Center ◽  
Ischemic Encephalopathy ◽  
Single Center Observational Study

Therapeutic hypothermia for hypoxic-ischemic encephalopathy after perinatal sentinel events: less brain injury on MRI and improved neurodevelopmental outcome at 18–36 months

2020 ◽  
Vol 40 (4) ◽  
pp. 633-639 ◽  
Author(s):  
Beate Grass ◽  
Amr El Shahed ◽  
Linh G. Ly ◽  
Vann Chau ◽  
Helen M. Branson ◽  
...  
Keyword(s):  
Brain Injury ◽  
Therapeutic Hypothermia ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Sentinel Events ◽  
Ischemic Encephalopathy

scholarly journals Predictors of Outcomes in Hypoxic-Ischemic Encephalopathy following Hypothermia: A Meta-Analysis

Neonatology ◽  
2020 ◽  
Vol 117 (4) ◽  
pp. 411-427 ◽  
Author(s):  
Sabine Ouwehand ◽  
Lisanne C.A. Smidt ◽  
Jeroen Dudink ◽  
Manon J.N.L. Benders ◽  
Linda S. de Vries ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Therapeutic Hypothermia ◽  
Meta Analysis ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Spectroscopy ◽  
Test Accuracy ◽  
Neurodevelopmental Outcomes ◽  
Posterior Limb ◽  
Ischemic Encephalopathy

<b><i>Introduction:</i></b> Prediction of neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy remains an important challenge. Various studies have shown that the predictive ability of different modalities changed after the introduction of therapeutic hypothermia. This paper reviews the diagnostic test accuracy of the different modalities that are being used to predict neurodevelopmental outcomes following therapeutic hypothermia. <b><i>Methods:</i></b> A systematic literature search was performed using Embase and PubMed. Two reviewers independently included eligible studies and extracted data. The quality of the studies was assessed using the Quality in Prognosis Studies Tool. Meta-analyses were performed where possible. <b><i>Results:</i></b> Forty-seven articles and 3 conference abstracts were included, reporting on 3,072<i></i>infants of whom 39% died or had an adverse neurodevelopmental outcome. A meta-analysis could be performed using 37 articles on (amplitude-integrated) electroencephalography (EEG), conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and proton magnetic resonance spectroscopy (<sup>1</sup>H-MRS). Amplitude-integrated EEG (aEEG) at 24 and 72 h showed similar high diagnostic OR, while aEEG at 6 h and EEG performed less, both due to a low specificity. For MRI, most studies reported scoring systems in which early (&#x3c;8 days) MRI performed better than late (≥8 days) MRI. Injury to the posterior limb of the internal capsule on MRI or to the thalami on DWI were strong individual predictors, as was an increased lactate/N-acetylaspartate peak on <sup>1</sup>H-MRS. <b><i>Conclusions:</i></b> In the era of therapeutic hypothermia, the different modalities remain good predictors of neurodevelopmental outcome. However, timing should be taken into account. aEEG may initially be false positive and gets more reliable after 24 h. In contrast, MRI should be used during the first week, as its predictive value decreases afterwards.

Visual outcomes in children with neonatal hypoxic ischemic encephalopathy treated with therapeutic hypothermia

2021 ◽  
Author(s):  
Jerry Hsu ◽  
Noreen Shaikh ◽  
Hantamalala Ralay Ranaivo ◽  
Andrea C. Pardo ◽  
Rebecca B. Mets-Halgrimson
Keyword(s):  
Therapeutic Hypothermia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Visual Outcomes ◽  
Ischemic Encephalopathy

scholarly journals Inhaled H2 or CO2 Do Not Augment the Neuroprotective Effect of Therapeutic Hypothermia in a Severe Neonatal Hypoxic-Ischemic Encephalopathy Piglet Model

2020 ◽  
Vol 21 (18) ◽  
pp. 6801
Author(s):  
Viktória Kovács ◽  
Gábor Remzső ◽  
Valéria Tóth-Szűki ◽  
Viktória Varga ◽  
János Németh ◽  
...  
Keyword(s):  
Caudate Nucleus ◽  
Therapeutic Hypothermia ◽  
Neuroprotective Effect ◽  
Fold Increase ◽  
Hypoxic Ischemic Encephalopathy ◽  
Mrna Levels ◽  
Treatment Groups ◽  
Apoptosis Inducing Factor ◽  
Co2 Treatment ◽  
Ischemic Encephalopathy

Hypoxic-ischemic encephalopathy (HIE) is still a major cause of neonatal death and disability as therapeutic hypothermia (TH) alone cannot afford sufficient neuroprotection. The present study investigated whether ventilation with molecular hydrogen (2.1% H2) or graded restoration of normocapnia with CO2 for 4 h after asphyxia would augment the neuroprotective effect of TH in a subacute (48 h) HIE piglet model. Piglets were randomized to untreated naïve, control-normothermia, asphyxia-normothermia (20-min 4%O2–20%CO2 ventilation; Tcore = 38.5 °C), asphyxia-hypothermia (A-HT, Tcore = 33.5 °C, 2–36 h post-asphyxia), A-HT + H2, or A-HT + CO2 treatment groups. Asphyxia elicited severe hypoxia (pO2 = 19 ± 5 mmHg) and mixed acidosis (pH = 6.79 ± 0.10). HIE development was confirmed by altered cerebral electrical activity and neuropathology. TH was significantly neuroprotective in the caudate nucleus but demonstrated virtually no such effect in the hippocampus. The mRNA levels of apoptosis-inducing factor and caspase-3 showed a ~10-fold increase in the A-HT group compared to naïve animals in the hippocampus but not in the caudate nucleus coinciding with the region-specific neuroprotective effect of TH. H2 or CO2 did not augment TH-induced neuroprotection in any brain areas; rather, CO2 even abolished the neuroprotective effect of TH in the caudate nucleus. In conclusion, the present findings do not support the use of these medical gases to supplement TH in HIE management.

scholarly journals Biomarkers of hepatic injury and function in neonatal hypoxic ischemic encephalopathy and with therapeutic hypothermia

2017 ◽  
Vol 176 (10) ◽  
pp. 1295-1303 ◽  
Author(s):  
Hemananda Muniraman ◽  
Danielle Gardner ◽  
Jane Skinner ◽  
Anna Paweletz ◽  
Anitha Vayalakkad ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Hepatic Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
And Function ◽  
Ischemic Encephalopathy

Pharmacokinetics of Gentamicin in Newborns with Moderate-to-Severe Hypoxic-Ischemic Encephalopathy Undergoing Therapeutic Hypothermia

2014 ◽  
Vol 82 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Joseph Y. Ting ◽  
Eddie Kwan ◽  
Al McDougal ◽  
Horacio Osiovich
Keyword(s):  
Therapeutic Hypothermia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Ischemic Encephalopathy

Therapeutic Hypothermia in Neonatal Hypoxic Ischemic Encephalopathy: Electrographic Seizures and Magnetic Resonance Imaging Evidence of Injury

2013 ◽  
Vol 163 (2) ◽  
pp. 465-470 ◽  
Author(s):  
Preethi Srinivasakumar ◽  
John Zempel ◽  
Michael Wallendorf ◽  
Russell Lawrence ◽  
Terrie Inder ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Therapeutic Hypothermia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Evidence ◽  
Electrographic Seizures ◽  
Ischemic Encephalopathy
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