Naloxone for preventing morbidity and mortality in newborn infants of greater than 34 weeks' gestation with suspected perinatal asphyxia

McGuire, William; Fowlie, Peter W; Evans, David

doi:10.1002/14651858.cd003955.pub2

Cited by 10 publications

(3 citation statements)

References 24 publications

(2 reference statements)

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“…Naloxone is an opioid antagonist that blocks the effects of an opioid and reverses neonatal depression [2]. The Neonatal Resuscitation Program suggests naloxone should only be given to infants with severe respiratory depression after positive pressure ventilation has restored a normal heart rate and color and there is a history of maternal narcotic administration within the past four hours [13,14]. Maternal narcotic administration was two hours before delivery in our case and naloxone was given at eight hours of life.…”

Section: Table 1: Etiologies Of Cardiorespiratory and Neurological Depression In A Neonatementioning

confidence: 96%

Reversal of Opioid Intoxication in an Infant With Intrauterine Growth Restriction With a Single Dose of Naloxone

Timalsina

Andrasovich

Kupferman

et al. 2021

Cureus

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Perinatal exposure to opioids might result in opioid intoxication in a newborn infant. The routine use of naloxone in an opioid-exposed newborn infant is discouraged due to the risks of precipitating withdrawal and long-term developmental problems associated with naloxone. We describe a case of respiratory and neurological depression in an infant with intrauterine growth restriction (IUGR) following in utero exposure to an opioid two hours before delivery. The infant was apneic with a poor tone immediately after birth. With positive pressure ventilation, the tone and respiratory effort improved, and the baby was admitted to the neonatal intensive care unit (NICU) on oxygen support via nasal cannula. The baby started having bradypnea with shallow breathing and oxygen desaturation at eight hours of life, most likely secondary to intrauterine exposure to hydromorphone which was successfully reversed with a single dose of intravenous naloxone. The infant was discharged on day of life seven with no further symptoms. Naloxone administration might be considered in an IUGR infant with persistent cardiorespiratory and neurological depression who has a history of intrauterine opioid exposure within four hours before delivery provided the mother is not narcotic dependent.

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Section: Table 1: Etiologies Of Cardiorespiratory and Neurological Depression In A Neonatementioning

confidence: 96%

Reversal of Opioid Intoxication in an Infant With Intrauterine Growth Restriction With a Single Dose of Naloxone

Timalsina

Andrasovich

Kupferman

et al. 2021

Cureus

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“…In these sense, up to the present moment, some of the most useful therapies have been appeared, such as N -acetylcysteine and allopurinol, magnesium sulfate, glutamate receptor blockers, erythropoietin and hypothermia [ 52 ]. These pharmacological and non-pharmacological interventions progress to minimize the extent of damage along the evolving process after HI brain injury [ 53 , 54 , 55 , 56 , 57 , 58 ].…”

Section: Neuroprotective Therapiesmentioning

confidence: 99%

Neuroprotective Therapies after Perinatal Hypoxic-Ischemic Brain Injury

et al. 2013

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Hypoxic-ischemic (HI) brain injury is one of the main causes of disabilities in term-born infants. It is the result of a deprivation of oxygen and glucose in the neural tissue. As one of the most important causes of brain damage in the newborn period, the neonatal HI event is a devastating condition that can lead to long-term neurological deficits or even death. The pattern of this injury occurs in two phases, the first one is a primary energy failure related to the HI event and the second phase is an energy failure that takes place some hours later. Injuries that occur in response to these events are often manifested as severe cognitive and motor disturbances over time. Due to difficulties regarding the early diagnosis and treatment of HI injury, there is an increasing need to find effective therapies as new opportunities for the reduction of brain damage and its long term effects. Some of these therapies are focused on prevention of the production of reactive oxygen species, anti-inflammatory effects, anti-apoptotic interventions and in a later stage, the stimulation of neurotrophic properties in the neonatal brain which could be targeted to promote neuronal and oligodendrocyte regeneration.

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“…Beim Opiatüberhang kann die intravenöse Injektion von Naloxon (0,1 mg/kg) die Notwendigkeit der Beatmung nicht reduzieren (E1a) [25], für andere Ursachen der Asphyxie ist das Medikament wirkungslos (E1b) [26].…”

Section: 3 Kreislaufadaptationunclassified

Gestörte postnatale Adaptation

Obladen¹

Neugeborenen-Intensivmedizin

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Unmittelbar nach der Geburt müssen sich alle wichtigen Vitalfunktionen des Kindes umstellen: Es besteht keine Verbindung mehr zu Eihäuten und Plazenta, die bislang Isolierung, Ernährung, Ausscheidung und Gasaustausch gewährleistet haben. Der im Wasser lebende Fetus wird zum Luft atmenden Neugeborenen und muss für Atmung, Kreislauf, Wärmeregulation, Ernährung, Stoffwechsel, Ausscheidung sowie für die Infektabwehr selbst sorgen. Da die Umstellungsvorgänge nach der Geburt leicht störbar sind -besonders, wenn das Kind unreif zur Welt kommt -, ist eine möglichst genaue Diagnostik in den ersten Lebensminuten und -stunden erforderlich.

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Naloxone for preventing morbidity and mortality in newborn infants of greater than 34 weeks' gestation with suspected perinatal asphyxia

Cited by 10 publications

References 24 publications

Reversal of Opioid Intoxication in an Infant With Intrauterine Growth Restriction With a Single Dose of Naloxone

Reversal of Opioid Intoxication in an Infant With Intrauterine Growth Restriction With a Single Dose of Naloxone

Neuroprotective Therapies after Perinatal Hypoxic-Ischemic Brain Injury

Gestörte postnatale Adaptation

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