Antioxidants in Hypoxic 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.

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Hypoxic-ischemic Encephalopathy: Therapeutic Approaches Against Microvascular Injury, and Role of Neutrophils, PAF, and Free Radicals

Clinics in Perinatology ◽

10.1016/s0095-5108(18)30294-x ◽

1995 ◽

Vol 22 (2) ◽

pp. 481-517 ◽

Cited By ~ 76

Author(s):

Charles Palmer

Keyword(s):

Free Radicals ◽

Hypoxic Ischemic Encephalopathy ◽

Therapeutic Approaches ◽

Microvascular Injury ◽

Ischemic Encephalopathy

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171813 ◽

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.

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

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.581 ◽

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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Perinatal Asphyxia with Hyperoxemia within the First Hour of Life Is Associated with Moderate to Severe Hypoxic-Ischemic Encephalopathy

The Journal of Pediatrics ◽

10.1016/j.jpeds.2013.04.043 ◽

2013 ◽

Vol 163 (4) ◽

pp. 949-954 ◽

Cited By ~ 36

Author(s):

Vishal S. Kapadia ◽

Lina F. Chalak ◽

Tara L. DuPont ◽

Nancy K. Rollins ◽

Luc P. Brion ◽

...

Keyword(s):

Perinatal Asphyxia ◽

Hypoxic Ischemic Encephalopathy ◽

Ischemic Encephalopathy

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Role of 20‐HETE in neuronal signaling and contribution to neonatal hypoxic‐ischemic encephalopathy

The FASEB Journal ◽

10.1096/fasebj.26.1_supplement.711.4 ◽

2012 ◽

Vol 26 (S1) ◽

Author(s):

Raymond C Koehler ◽

Zeng-Jin Yang ◽

Erin L Carter ◽

Kathleen K Kibler ◽

Herman Kwansa ◽

...

Keyword(s):

Hypoxic Ischemic Encephalopathy ◽

Neuronal Signaling ◽

Ischemic Encephalopathy

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The Effect of the Excretion of Calcium, Magnesium, and Phosphate on the Serum Levels of These Substances in Newborns Who Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy

10.21203/rs.3.rs-244271/v1 ◽

2021 ◽

Author(s):

Osman Baştuğ ◽

Bahadır İnan ◽

Ahmet Özdemir ◽

Binnaz Çelik ◽

Funda Baştuğ ◽

...

Keyword(s):

Urinary Excretion ◽

Therapeutic Hypothermia ◽

Perinatal Asphyxia ◽

Serum Levels ◽

Hypoxic Ischemic Encephalopathy ◽

Control Group ◽

P Value ◽

Electrolyte Disturbances ◽

Significant Difference ◽

Ischemic Encephalopathy

Abstract Background: Hypocalcemia, hypomagnesemia, and hyperphosphatemia are common electrolyte disturbances in perinatal asphyxia(PA). Different reasons have been proposed for these electrolyte disturbances. This study investigated the effect of the urinary excretion of calcium(Ca), magnesium(Mg), and phosphorus(P) on the serum levels of these substances in babies who were treated using therapeutic hypothermia for hypoxic ischemic encephalopathy(HİE) caused by PA. This study sheds light on the pathophysiology that may cause changes in the serum values of these electrolytes.Method: This study included 21 healthy newborns(control group) and 38 patients(HİE group) who had undergone therapeutic hypothermia due to HİE. Only infants with a gestational age of 36 weeks and above and a birth weight of 2000 g and above were evaluated. The urine and serum Ca, Mg, P, and creatinine levels of all infants were evaluated at 24, 48, and 72 hours.Results: The lower serum Ca value and the higher serum P value of the HİE group were found to be statistically significant compared to the control group. There was no significant difference in serum Mg values between the groups. However, hypomagnesemia was detected in five patients from the HİE group. The urine excretions of these substances, which were checked at different times, were found to be significantly higher in the HİE group compared to the control group.Conclusion: This study determined that the urinary excretion of Ca, Mg, and P has an effect on the serum Ca, Mg, and P levels of infants with HİE.

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Clinical Profile and Short-Term Outcome of Neonatal Seizures in a Tertiary Care Hospital, Kuppam – A Retrospective Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/442 ◽

2021 ◽

Vol 8 (27) ◽

pp. 2381-2386

Author(s):

Poojitha Kancherla ◽

Harsha P.J. ◽

Gowtham R. ◽

Dowlath Anwar Basha ◽

Chandran G.P ◽

...

Keyword(s):

Tertiary Care ◽

Clinical Profile ◽

Hypoxic Ischemic Encephalopathy ◽

Care Hospital ◽

Neonatal Seizures ◽

Metabolic Disturbances ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Ischemic Encephalopathy

BACKGROUND Neonates presenting with seizures require long term stay in hospital and have higher chances of neuro-developmental delay later. Seizures in neonates are mostly subtle and difficult to diagnose. We wanted to study the clinical profile and short-term outcome on term and later pre-term neonates presenting with seizures. METHODS The study was a retrospective observational study done from November to December 2020 at PES Hospital, Kuppam. Retrospective data of neonatal seizures from May 2019 to April 2020 was considered for study. Details from the case records of neonates with seizures was collected. RESULTS Neonatal seizures (NS) were most common in females (53.8 %, 72/134). Subtle seizures were most common form of seizures in neonates which was seen in 64.2 % (86/134) babies followed by tonic seizures in 22.4 % (30/134). Neonatal seizures were most commonly seen in babies with hypoxic ischemic encephalopathy in 63.4 % (85/134) followed by metabolic disturbances in 15.6 % (21/134) and meningitis in 13.5 % (18/134). In babies with hypoxic ischemic encephalopathy, metabolic and meningitis subtle seizures were observed to be more common. Seizures were seen most commonly in first 72 hours of life (82.85 %, 111/134). Seizures in babies with hypoxic ischemic encephalopathy, metabolic causes most commonly occurred within first 24 hours of birth. Seizures in babies with meningitis most commonly occurred after 7 days of birth. Babies with neonatal seizures with sequelae was seen in 17.96 % (24/134) and 11.94 % babies died (16/134). CONCLUSIONS Subtle seizures were most common form and hypoxic ischemic encephalopathy was most common risk factor. Most neonatal seizures present within 72 hours of birth. Babies with meningitis presented with seizures most commonly after 72 hours of birth. KEYWORDS Hypoxic Ischemic Encephalopathy, Neonatal Seizures, Newborn, Aetiology, Outcome

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