Does abnormal Doppler on cranial ultrasound predict disability in infants with hypoxic‐ischaemic encephalopathy? A systematic review

Rath, Chandra; Rao, Shripada; Suryawanshi, Pradeep; Desai, Saumil; Chetan, Chinmay; Patil, Karamchand; Patole, Sanjay

doi:10.1111/dmcn.15236

Cited by 4 publications

(2 citation statements)

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“…Rath et al 30 systematically reviewed 26 studies and evaluated the importance of Doppler parameters in predicting longterm outcomes following perinatal asphyxia. They separately analyzed studies from the precooling and cooling eras.…”

Section: Perinatal Asphyxiamentioning

confidence: 99%

Transcranial Doppler: A New Stethoscope–Voiceover Tool for Neonatal Brain

Maheshwari,

Patodia,

Suryawanshi

et al. 2024

Newborn

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Background: Cerebral Doppler ultrasound is an emerging bedside tool to measure cerebral perfusion in premature and critically ill neonates. The review focused on maturation and disease-associated Doppler spectra in neonates for diagnostic and prognostic relevance and to identify relevant research areas. Methods: A comprehensive literature search was conducted to review cerebral Doppler parameters noted in specific disease states. Further efforts were focused to understand the clinical relevance of these indices in the management of neonates and to predict their long-term neurodevelopmental outcomes. Results: The review focused on routinely used cerebral Doppler parameters in normal and diseased states. Resistive index (RI) in the anterior cerebral artery (ACA) is a frequently used parameter in infants with primary brain injury and in preterm neonates with hemodynamically significant patent ductus arteriosus (HsPDA). Conclusion: Despite extensive use, major gaps remain in our understanding of cerebral Doppler parameters for diagnosis, monitoring, and prediction of neurodevelopmental outcomes in neonates. Further studies are needed to decode these data in a more precise manner.

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Section: Perinatal Asphyxiamentioning

confidence: 99%

Transcranial Doppler: A New Stethoscope–Voiceover Tool for Neonatal Brain

Maheshwari,

Patodia,

Suryawanshi

et al. 2024

Newborn

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“…17 Similarly, highly abnormal resistive indices or cerebral blood flow measured on transcranial doppler prior to initiation of hypothermia may be able to predict death or severe disability. 18 However, both EEG and transcranial doppler technology still require expensive additional equipment and trained staff to read and accurately interpret the recordings.…”

Section: Introductionmentioning

confidence: 99%

Temperature dysregulation during therapeutic hypothermia predicts long-term outcome in neonates with HIE

Mietzsch

Flibotte

Law

et al. 2023

J Cereb Blood Flow Metab

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Few reliable or easily obtainable biomarkers to predict long-term outcome in infants with hypoxic-ischemic encephalopathy (HIE) have been identified. We previously showed that mattress temperature (MT), as proxy for disturbed temperature regulation during therapeutic hypothermia (TH), predicts injury on early MRI and holds promise as physiologic biomarker. To determine whether MT in neonates treated with TH for moderate-severe HIE is associated with long-term outcome at 18–22 months, we performed a secondary analysis of the Optimizing Cooling trial using MT data from 167 infants treated at a core temperature of 33.5°C. Median MTs from four time-epochs (0–6 h, 6–24 h, 24–48 h, and 48–72 h of TH) were used to predict death or moderate-severe neurodevelopmental impairment (NDI), using epoch-specific derived and validated MT cutoffs. Median MT of infants who died or survived with NDI was consistently 1.5–3.0°C higher throughout TH. Infants requiring a median MT above the derived cut-offs had a significantly increased odds of death or NDI, most notably at 0–6 h (aOR 17.0, 95%CI 4.3–67.4). By contrast, infants who remained below cut-offs across all epochs had 100% NDI-free survival. MTs in neonates with moderate-severe HIE during TH are highly predictive of long-term outcome and can be used as physiologic biomarker.

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