Cooling for newborns with hypoxic ischaemic encephalopathy

Jacobs, Susan E; Hunt, Rod W; Tarnow‐Mordi, William; Inder, Terrie E.; Davis, Peter G

doi:10.1002/14651858.cd003311

Cited by 459 publications

(698 citation statements)

References 32 publications

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“…All meta-analyses of several main trials and well-described phase I and II randomized studies, which included outcome information, demonstrate consistent relative risk of death or disability of B0.75 and a 95% confidence interval between 0.60 and 0.90. [53][54][55][56] The four trials had similar incidence of primary outcome among control groups, and similar incidence of primary outcome among the intervention groups (40-50%). It is however, important to note that hypothermia results in a reduction in risk of death or disability from 58% to only 47%, suggesting the need for adjunct therapies, such as stem cell regenerative therapy.…”

Section: Limited Endogenous Neurogenesis Following Hypoxic Ischemic Imentioning

confidence: 85%

“…56 In the more recently published Total Body Hypothermia trial, mortality was the same for cooled and regular care, but among survivors, the incidence of CP was significantly decreased in cooled infants (28%) as compared with controls (40%) (P ¼ 0.03). 57 The results of multicenter human clinical trials indicate that the critical period for initiation of cooling appears to occur within the first 6 postnatal hours; an on-going NICHD study is examining whether later initiation of cooling, after the first 6 postnatal hours, will be as effective (ClinicalTrials.gov # NCT00614744).…”

Section: Limited Endogenous Neurogenesis Following Hypoxic Ischemic Imentioning

confidence: 92%

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Rescuing the neonatal brain from hypoxic injury with autologous cord blood

Liao

Cotten

Tan

et al. 2012

Bone Marrow Transplant

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Brain injury resulting from perinatal hypoxic-ischemic encephalopathy (HIE) is a major cause of acute mortality in infants and chronic neurologic disability in surviving children. Recent multicenter clinical trials demonstrated the effectiveness of hypothermia initiated within the first 6 postnatal hours to reduce the risk of death or major neurological disabilities among neonates with HIE. However, in these trials, approximately 40% of cooled infants died or survived with significant impairments. Therefore, adjunct therapies are required to improve the outcome in neonates with HIE. Cord blood (CB) is a rich source of stem cells. Administration of human CB cells in animal models of HIE has generally resulted in improved outcomes and multiple mechanisms have been suggested including anti-inflammation, release of neurotrophic factors and stimulation of endogenous neurogenesis. Investigators at Duke are conducting studies of autologous CB infusion in neonates with HIE and in children with cerebral palsy. These pilot studies indicate no added risk from the regimens used, but results of ongoing placebo-controlled trials are needed to assess efficacy. Meanwhile, further investigations are warranted to determine the best strategies, that is, timing, dosing, route of delivery, choice of stem cells and ex vivo modulations, to attain long-term benefits of CB stem cell therapy.

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Section: Limited Endogenous Neurogenesis Following Hypoxic Ischemic Imentioning

confidence: 85%

Section: Limited Endogenous Neurogenesis Following Hypoxic Ischemic Imentioning

confidence: 92%

Rescuing the neonatal brain from hypoxic injury with autologous cord blood

Liao

Cotten

Tan

et al. 2012

Bone Marrow Transplant

View full text Add to dashboard Cite

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“…They also might represent punctiform hemorrhages that developed during hypothermia. Indeed hypothermia treatment might increase the risk of brain hemorrhages because it increases the risk of thrombocytopenia and has been suggested as a risk factor for intraventricular hemorrhage [45,46]. The other neonate with an early MRI performed on day 3 had abnormal early MRI (severe central injuries) and abnormal late MRI (diffuse pattern).…”

Section: Signal Changes In the Posterior Limb Of Internal Capsule (Plic)mentioning

confidence: 99%

Comparison of early and late MRI in neonatal hypoxic–ischemic encephalopathy using three assessment methods

Charon¹,

Proisy²,

Ferré³

et al. 2015

Pediatr Radiol

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“…Die Richtlinien beschränken sich auf den Hin weis, dass eine Hyperthermie vermieden werden soll [1,2,3,6]. In der Zwischenzeit sind weitere Studien publiziert worden, die zusammen mit den früheren Studien die neuroprotektive Wirkung der therapeu tischen Hypothermie robust belegen [27]. Kürzlich hat eine Expertengruppe vorge schlagen, dass die aktuell gültigen Emp fehlungen dringend revidiert werden soll ten ("interim advisory statement"), damit diese Therapieform in die klinische Praxis integriert werden kann [23].…”

Section: Therapeutische Hypothermieunclassified

Reanimation des Neugeborenen

Berger

Pilgrim

2008

Anaesthesist

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Although almost 10% of all newborn infants need some form of respiratory assistance after birth, only 1% will require more advanced forms of resuscitation. Because these rare events cannot always be anticipated, pediatricians and neonatologists may not be readily available and resuscitation will have to be performed by anesthesiologists. In recent years, international guidelines for neonatal resuscitation have been revised by the International Liaison Committee on Resuscitation (ILCOR), the American Academy of Pediatrics (AAP) and the American Heart Association (AHA), as well as the European Resuscitation Council (ERC). The revised guidelines describe a simplified resuscitation algorithm which emphasizes the central role of respiratory support and an increase in heart rate is judged to be the best marker for successful ventilation. In deliveries complicated by meconium-stained amniotic fluid, intrapartum suctioning of the oropharynx is no longer recommended and endotracheal suctioning is restricted to severely depressed babies. The new guidelines mention the use of the laryngeal mask airway (LMA) and CO(2) detectors without, however, making firm recommendations. The use of 100% oxygen in neonatal resuscitation is increasingly being challenged. In the rare event of a newborn whose heart rate drops below 60 beats/min, more advanced resuscitation (chest compressions using the 2-thumb-encircling-hands technique, epinephrine 10-30 mug/kgBW i.v.) will be required. Finally, the guidelines mention the possible neuroprotective effect of therapeutic hypothermia after asphyxia, but finally only recommend that hyperthermia should be avoided.

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Cooling for newborns with hypoxic ischaemic encephalopathy

Cited by 459 publications

References 32 publications

Rescuing the neonatal brain from hypoxic injury with autologous cord blood

Rescuing the neonatal brain from hypoxic injury with autologous cord blood

Comparison of early and late MRI in neonatal hypoxic–ischemic encephalopathy using three assessment methods

Reanimation des Neugeborenen

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