scholarly journals Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy

2019 ◽  
Vol 9 (3) ◽  
pp. 160-165
Author(s):  
Bithi Debnath ◽  
Naila Zaman Khan ◽  
Dilara Begum ◽  
Asma Begum Shilpi ◽  
Shaheen Akter
Keyword(s):  
Elevated Temperature ◽  
Rectal Temperature ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Term Neonates ◽  
Risk Of Death ◽  
The Mean ◽  
Ischemic Encephalopathy

Background: Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy. Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth. Materials and Methods: This was a prospective observational study. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infant`s temperature for each site were rank ordered. Then mean of all axillary and rectal temperatures of each neonate was calculated. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender. Results: The mean axillary temperature was 36.07 ± 6.10C and in 25.71%, 11.92% and 6.32% cases axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and in 43.53%, 30.02% and 19.97% cases rectal temperatures were >370C, >37.50C and >380C respectively. Mean ambient temperature was 26.170C. There was significant correlation between axillary and rectal temperatures (r=0.889). For elevated temperature, the odds of death or moderate to severe impairment increased 8.9-fold (CI 0.906–88.18) and the odds of death alone increased 4.6-fold (CI 0.373–56.83). The odds of impairment increased 1.84-fold (CI 0.45– 7.50). Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes. J Enam Med Col 2019; 9(3): 160-165

scholarly journals Severity and immediate neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy admitted in NICU at a tertiary hospital in Bangladesh

2021 ◽  
Vol 9 (1) ◽  
pp. 22-27
Author(s):  
Bithi Debnath ◽  
Naila Zaman Khan ◽  
Rumana Mahfuz ◽  
Abid Hossain Mollah
Keyword(s):  
Assessment Tool ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurological Deficits ◽  
Care Hospital ◽  
Neurodevelopmental Outcomes ◽  
Term Neonates ◽  
Ischemic Encephalopathy

Background: Neonatal hypoxic ischemic encephalopathy (HIE) is a major cause of mortality, morbidity and long-term neurological deficits. Objective: The aim of the study was to determine the severity of encephalopathy and immediate neurodevelopmental outcomes in term neonates with HIE admitted in NICU at a tertiary care hospital. Materials and Methods: This was a Prospective Cohort study conducted between July 2016 and June 2017 at Dhaka Medical college Hospital, Dhaka. Asphyxiated term newborns who came within 12 hours of birth were enrolled in this study. Sarnat and Sarnat score was used to assess newborns immediately after birth to classify HIE. Neurodevelopmental assessment was performed using age specific rapid neurodevelopmental assessment tool (RNDA) at and 3 months after discharge to identify impairment in specific developmental domains. We determined the relation between severity of HIE and clinical outcome. Results: 60 patients were included in this study and their mean duration of hospital stay was 7.19 ± 5.26 days. The majority, 40% had moderate HIE, followed by 33.33%, 26.67% that had mild and severe HIE respectively. A total of 20% died, and most of them had severe HIE (83.33%). Normal development was found in only 11.67% cases. Moderate and severe neurodevelopmental impairment (NDI) was found in 33.33% and 25% cases respectively. At discharge, the most severely impaired domains were speech, seizure, primitive reflex and behaviour whereas at 3 months of age it was gross motor and seizure. When neurodevelopmental outcome was compared with different stages of encephalopathy, significant association was found between moderate to severe impairment/death with stage III of HIE. Conclusion: Apart from mortality, a significant proportion of term neonates with HIE developed NDIs and adverse neurodevelopmental outcomes was significantly associated with severity of encephalopathy. Bangladesh Crit Care J March 2021; 9(1): 22-27

scholarly journals Association between Urinary Lactate to Creatinine Ratio and Neurodevelopmental Outcome in Term Infants with Hypoxic-Ischemic Encephalopathy

2008 ◽  
Vol 153 (3) ◽  
pp. 375-378.e2 ◽  
Author(s):  
William Oh ◽  
Rebecca Perritt ◽  
Seetha Shankaran ◽  
Matthew Merritts ◽  
Edward F. Donovan ◽  
...  
Keyword(s):  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Creatinine Ratio ◽  
Term Infants ◽  
Ischemic Encephalopathy

scholarly journals Dexmedetomidine for Sedation of Neonates with HIE Undergoing Therapeutic Hypothermia: A Single-Center Experience

2018 ◽  
Vol 08 (03) ◽  
pp. e168-e173 ◽  
Author(s):  
Keliana O'Mara ◽  
Michael Weiss
Keyword(s):  
Therapeutic Hypothermia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Limited Data ◽  
Single Center ◽  
Short Term ◽  
Term Neonates ◽  
Risk Of Death ◽  
Single Center Experience ◽  
Dexmedetomidine Infusion ◽  
Ischemic Encephalopathy

AbstractHypoxic-ischemic encephalopathy (HIE) is a significant cause of morbidity and mortality in neonates. Therapeutic hypothermia reduces the risk of death or disability. Providing optimal sedation while neonates are undergoing therapeutic hypothermia is likely beneficial but may present therapeutic challenges. There are limited data describing the use of dexmedetomidine for sedation in patients undergoing therapeutic hypothermia. The objective of this study is to evaluate the efficacy and short-term safety of dexmedetomidine infusion for sedation in term neonates undergoing therapeutic hypothermia for HIE.

scholarly journals Predictive value of color doppler neuro-sonography for the development of neurological sequels in newborn infants with hypoxic ischemic encephalopathy

2011 ◽  
Vol 68 (10) ◽  
pp. 825-831
Author(s):  
Brankica Vasiljevic ◽  
Svjetlana Maglajlic-Djukic ◽  
Sanja Stankovic ◽  
Dragana Lutovac ◽  
Miroslava Gojnic
Keyword(s):  
Predictive Value ◽  
Color Doppler ◽  
Newborn Infants ◽  
Neurodevelopmental Outcome ◽  
Staging System ◽  
Hypoxic Ischemic Encephalopathy ◽  
Clinical Staging ◽  
Neurodevelopmental Outcomes ◽  
Significant Difference ◽  
Ischemic Encephalopathy

Background/Aim. The use of color Doppler neurosonography (cD-US) allows simultaneous examination of parenchymal and vascular cerebral structures. Evaluation of cerebral blood flow velocities (CBFV) and vascular resistance are important in assessment of cerebral circulation in neonates with hypoxic ischemic encephalopathy (HIE). The aim of this study was to evaluate the predictive value of cD-US for abnormal neurodevelopmental outcome in the neonates with HIE. Methods. A total of 90 neonates (>32 weeks gestational age) with HIE were enrolled prospectively. All the neonates with HIE were categorized into three grades according to the Sarnat and Sarnat clinical staging system: mild HIE, moderate HIE, and severe HIE. cD-US was performed simultaneously during the first 24 h of life. Neurodevelopment outcome was assessed at 12 months of age in all the neonates. Resluts. The values of CBFV and the values of index resistance (RI) correlated with the severity of HIE (p < 0.0001) and subsequent neurodevelopmental outcome (p < 0.001). We detected a significant difference in values of CBFV and in values of RI between preterm and full-term neonates (p < 0.01). The cut-off value of RI for poor neurodevelopmental outcomes was 0.81. Conclusions. cD-US could be very useful and safe diagnostic tool for assessing severity of HIE and subsequent adverse neurodevelopmental outcome.

Effect of Therapeutic Hypothermia on the Outcome in Term Neonates with Hypoxic Ischemic Encephalopathy—A Randomized Controlled Trial

2020 ◽  
Author(s):  
R Christina Catherine ◽  
Vishnu Bhat Ballambattu ◽  
Bethou Adhisivam ◽  
Shruthi K Bharadwaj ◽  
Chinnakali Palanivel
Keyword(s):  
Randomized Controlled Trial ◽  
Therapeutic Hypothermia ◽  
Brain Damage ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Hypoxic Ischemic Encephalopathy ◽  
Term Infants ◽  
Term Neonates ◽  
Randomized Controlled ◽  
Ischemic Encephalopathy

Abstract Objective To assess the effect of therapeutic hypothermia on the outcome in term neonates with hypoxic ischemic encephalopathy (HIE). Methods A randomized controlled trial was conducted in a tertiary care teaching hospital in south India. Term infants with moderate to severe HIE were randomized to be treated with normothermia or hypothermia. Mortality, neurological abnormality or normal outcome was recorded at hospital discharge or 28 days of age, whichever was earlier, and at 18 months of age. Results The baseline maternal and neonatal characteristics in the two groups were similar. The 78 infants in the hypothermia group had more normal survivors at discharge (38%) than the 84 infants in the normothermia group (30%), ratio 1.29 (95% confidence interval 0.84–1.99), and at 18 months of age (65% vs. 42%), ratio 1.54 (1.13–2.10). When these results were combined with those of a previous randomized trial in the same neonatal unit, there were significantly more normal survivors with hypothermia compared to normothermia at discharge, ratio 1.49 (1.18–1.88) and at 6–18 months of age, ratio 1.37 (1.17–1.60). Conclusion In term infants with HIE, therapeutic hypothermia reduced mortality and neurological abnormalities, and resulted in more normal survivors. LAY SUMMARY Babies who do not breathe immediately after they are born are likely to die or have brain damage. Previous studies have suggested that cooling these babies after birth might reduce the number who die or have brain damage. In this resource-limited setting, babies who were cooled were less likely to die or survive with brain damage.

scholarly journals Pathophysiology of Cerebral Hyperperfusion in Term Neonates With Hypoxic-Ischemic Encephalopathy: A Systematic Review for Future Research

2021 ◽  
Vol 9 ◽  
Author(s):  
Dianne G. Kleuskens ◽  
Filipe Gonçalves Costa ◽  
Kim V. Annink ◽  
Agnes van den Hoogen ◽  
Thomas Alderliesten ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Methodological Quality ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Future Research ◽  
Hemodynamic Changes ◽  
Term Neonates ◽  
Cerebral Hyperperfusion ◽  
Cerebral Vasodilation ◽  
Ischemic Encephalopathy

Worldwide neonatal hypoxic-ischemic encephalopathy (HIE) is a common cause of mortality and neurologic disability, despite the implementation of therapeutic hypothermia treatment. Advances toward new neuroprotective interventions have been limited by incomplete knowledge about secondary injurious processes such as cerebral hyperperfusion commonly observed during the first 1–5 days after asphyxia. Cerebral hyperperfusion is correlated with adverse neurodevelopmental outcome and it is a process that remains poorly understood. In order to provide an overview of the existing knowledge on the pathophysiology and highlight the gaps in current understanding of cerebral hyperperfusion in term animals and neonates with HIE, we performed a systematic research. We included papers scoping for study design, population, number of participants, study technique and relevant findings. Methodological quality was assessed using the checklist for cohort studies from The Joanna Briggs Institute. Out of 2,690 results, 34 studies were included in the final review—all prospective cohort studies. There were 14 studies of high, 17 moderate and 3 of low methodological quality. Data from the literature were analyzed in two main subjects: (1) Hemodynamic Changes subdivided into macro- and microscopic hemodynamic changes, and (2) Endogenous Pathways which was subdivided into N-methyl-D-aspartate/Mitogen activated protein kinase (NDMA/MAPK), Nitric Oxide (NO), prostanoids and other endogenous studies. Cerebral hyperperfusion in term neonates with HIE was found to be present 10–30 min after the hypoxic-ischemic event and was still present around day 10 and up to 1 month after birth. Cerebral hyperperfusion was also characterized by angiogenesis and cerebral vasodilation. Additionally, cerebral vasodilation was mediated by endogenous pathways such as MAPK through urokinase Plasminogen Activator (uPA), by neuronal NO synthase following NMDA and by prostanoid synthesis. Future research should elucidate the precise role of NMDA, MAPK and prostanoids in cerebral hyperperfusion. Moreover, research should focus on possible interventions and the effect of hypothermia on hyperperfusion. These findings should be taken into account simultaneously with brain imagining techniques, becoming a valuable asset in assessing the impact in neurodevelopmental outcome.

Prediction of neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy

2013 ◽  
Vol 17 (3) ◽  
pp. 288-293 ◽  
Author(s):  
Muzaffer Polat ◽  
Ayşe Şimşek ◽  
Nermin Tansuğ ◽  
Rabia G. Sezer ◽  
Mine Özkol ◽  
...  
Keyword(s):  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Term Neonates ◽  
Ischemic Encephalopathy
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