Cardiovascular dysfunction in infants with neonatal encephalopathy: Table 1

Armstrong, Kathryn; Franklin, Orla; Sweetman, Deirdre; Molloy, Eleanor J.

doi:10.1136/adc.2011.214205

Cited by 70 publications

(53 citation statements)

References 70 publications

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“…Newborns with asphyxia and HIE often suffer multiple organ failure as a result of the hypoxic-ischemic insult, including myocardial dysfunction (4). In the last years, therapeutic hypothermia (TH) has become standard of care for newborns with moderate-to-severe hypoxic-ischemic encephalopathy (HIE), as this treatment has been shown to improve survival and long-term neurodevelopment (5,6).…”

Section: Introductionmentioning

confidence: 99%

Preferential Cephalic Redistribution of Left Ventricular Cardiac Output during Therapeutic Hypothermia for Perinatal Hypoxic-Ischemic Encephalopathy

Hochwald

Jabr

Osiovich

et al. 2014

The Journal of Pediatrics

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Objective-To determine the relationship between left ventricular cardiac output (LVCO), superior vena cava (SVC) flow, and brain injury during whole-body therapeutic hypothermia.Study design-Sixteen newborns with moderate or severe hypoxic-ischemic encephalopathy were studied using echocardiography during and immediately after therapeutic hypothermia. Measures were also compared with 12 healthy newborns of similar postnatal age. Newborns undergoing therapeutic hypothermia also had a cerebral magnetic resonance imaging as part of routine clinical care on postnatal day 3-4.Results-LVCO was markedly reduced (mean+/−SD: 126+/−38 mL/kg/min) during therapeutic hypothermia, whereas SVC flow was maintained within expected normal values (88+/− 27 mL/kg/ min) such that it represented 70% of the LVCO. The reduction in LVCO during therapeutic hypothermia was mainly accounted by a reduction in heart rate (99 +/− 13 BPM versus 123 +/− 17 BPM; p<0.001) compared to immediately post-warming, in the context of myocardial dysfunction. Neonates with documented brain injury on MRI showed higher SVC flow pre-rewarming, compared to newborns without brain injury (p=0.013).Conclusion-Newborns with perinatal hypoxic-ischemic encephalopathy showed a preferential systemic-to cerebral redistribution of cardiac blood flow during whole-body therapeutic hypothermia, which may reflect a lack of cerebral vascular adaptation in newborns with more severe brain injury.

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Section: Introductionmentioning

confidence: 99%

Preferential Cephalic Redistribution of Left Ventricular Cardiac Output during Therapeutic Hypothermia for Perinatal Hypoxic-Ischemic Encephalopathy

Hochwald

Jabr

Osiovich

et al. 2014

The Journal of Pediatrics

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“…Cardiac dysfunction: Hypoxia-induced cardiac injury may manifest as hypotension [46]. Avoiding hypotension is important because of pressure passive cerebral circulation in asphyxiated neonates [47].…”

Section: Ventilation and Oxygenationmentioning

confidence: 99%

Preventing deaths from complications of labour and delivery

Buchmann

Stones

Thomas

2016

Best Practice & Research Clinical Obstetrics & Gynaecol

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The process of labour and delivery remains an unnecessary and preventable cause of death for women and babies around the world. Although rates of maternal and perinatal death are declining, there are large disparities between rich and poor countries, and sub-Saharan Africa has not seen the scale of declines shown elsewhere. In many areas, maternity services remain sparse and underequipped, with insufficient and poorly trained staff. Priorities for reducing the mortality burden are provision of safe caesarean section, prevention of sepsis, and appropriate care of women in labour in line with current best practices, appropriately and affordably delivered. A concern is that largescale recourse to caesarean delivery has its own dangers and may present new dominant causes for maternal mortality. An area of current neglect is newborn care. However, innovative training methods and appropriate technologies offer opportunities for affordable and effective newborn resuscitation and follow-up management in low-income settings.

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“…Estudios han demostrado que la fracción de acortamiento de ventrículo izquierdo (Favi) en RN asfixiado oscila en promedio entre 22-25% 12 , lo cual determina necesidad de apoyo precoz con inotrópos que aseguren óptima contractibilidad [13][14][15] .…”

Section: Terapia De Rescateunclassified

Consenso sobre manejo integral del neonato con encefalopatía hipóxico isquémica

et al. 2012

Rev. chil. pediatr.

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Consensus statement on integral management of the newborn with hypoxic-ischemic encephalopathyNeonatal encephalopathy secondary to birth asphyxia, the hypoxic ischemic encephalopathy, remains a major cause of postnatal death and neurological sequelae worldwide. supportive therapy has been the mainstay of treatment. Recently series of multicenter clinical trials show the benefits of therapeutic hypothermia in this high risk population. The International liaison Committee on Resuscitation (IlCOR) has recommended hypothermia as a standard of care and a beneficial therapy using the protocols followed in large clinical trials. Our objective was to develop a practical guide to be used at a national level in Chile, compatible with published protocols and standardized on an international basis, practical and compatible with the country's situation, and considering an integral management of the asphyxiated neonates, rescue and neuroprotective therapies. In summary, to establish rescue therapies, with the aim objective of support measures that promote cerebral and systemic oxygenation/perfusion, ensuring optimal cellular homeostasis, which are the basis of the rescue measures in asphyxiated neonates. Along with these rescue therapies, the objective is to perform the more beneficial neuroprotective therapy known today, hypothermia. Hypothermia should be conducted in a level 3 Neonatal Intensive Care unit, with multidisciplinary care and standardized protocols and also multidisciplinary follow-up and rehabilitation therapies.

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Cardiovascular dysfunction in infants with neonatal encephalopathy: Table 1

Cited by 70 publications

References 70 publications

Preferential Cephalic Redistribution of Left Ventricular Cardiac Output during Therapeutic Hypothermia for Perinatal Hypoxic-Ischemic Encephalopathy

Preferential Cephalic Redistribution of Left Ventricular Cardiac Output during Therapeutic Hypothermia for Perinatal Hypoxic-Ischemic Encephalopathy

Preventing deaths from complications of labour and delivery

Consenso sobre manejo integral del neonato con encefalopatía hipóxico isquémica

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