Hypothermia and coagulation defects in the newborn.

Chadd, M. A.; Gray, O.P.

doi:10.1136/adc.47.255.819

Cited by 59 publications

(21 citation statements)

References 10 publications

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“…Silverman et al [9] described increased mortality and morbidity in preterm infants maintained in cool incubators (28.9°C) over a trial period of 5 days when compared with infants in a warmer environmental temperature (31.7°C). Coagulation defects have been described in conditions of mild hypothermia in both piglets and infants [10,11] and other studies have suggested an increased association with infection [12,13].…”

Section: Discussionmentioning

confidence: 99%

Organ Pathology following Mild Hypothermia Used as Neural Rescue Therapy in Newborn Piglets

Amess

Penrice²,

Howard³

et al. 1997

Neonatology

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The aim of this study was to assess the possible adverse effects of hypothermia, used as neural rescue therapy in a newborn piglet model. Sixteen newborn piglets were subjected to transient cerebral hypoxia-ischaemia by temporary occlusion of the carotid arteries and reduction of the fractional inspired oxygen to 0.12. On resuscitation 11 piglets were maintained normothermic (38.5–39.0°C) and, in order to assess the cerebroprotective effect of hypothermia, 5 piglets were cooled to 35°C for 12 h before normothermia was resumed. At 48 or 64 h following resuscitation the animals were sacrificed and the heart, left kidney, specimens of distal small bowel, lung and liver were removed and histologically sectioned. No microscopic abnormalities of the heart, bowel or lung were observed in hypothermic or normothermic animals. All kidney specimens were normal except one from the normothermic group. Abnormal liver pathology suggestive of hypoperfusion injury was found in 5 normothermic and 3 hypothermic piglets. There was no significant difference in the proportion of piglets with liver abnormality between the two groups. Mild hypothermia following cerebral hypoxia-ischaemia in the newborn piglet was not associated with an increased incidence of non-cerebral organ damage. The hepatic injury observed may be related to umbilical venous catheterisation and has potential relevance to neonatal intensive care.

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Section: Discussionmentioning

confidence: 99%

Organ Pathology following Mild Hypothermia Used as Neural Rescue Therapy in Newborn Piglets

Amess

Penrice²,

Howard³

et al. 1997

Neonatology

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“…During the past decade, researchers have proceeded with caution in applying hypothermia, due to concern of possible side effects: cardiac arrhythmias [31], blood viscosity effects [32,33], pancreatic disorders [34], hypoglycemia [35], sepsis [36][37][38]. Azzopardi and Edwards [23] recently published a pilot study of treatment with wholebody hypothermia for asphyxiated newborns, using selection criteria very similar to ours -their results were encouraging.…”

Section: Discussionmentioning

confidence: 99%

Hypothermia Reduces Neurological Damage in Asphyxiated Newborn Infants

Compagnoni¹,

Pogliani²,

Lista³

et al. 2002

Neonatology

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Background: Perinatal asphyxia remains one of the most devastating neurologic processes. There is experimental and clinical evidence that cerebral cooling may suppress the biochemical cascades leading to delayed cerebral damage. Objective: To determine if hypothermia started soon after delivery reduces cerebral damage in term infants. Design/Methods: Retrospective chart analysis with historical controls. Ten asphyxiated newborns treated with hypothermia between October 1998 and October 1999 were compared to 11 asphyxiated newborns admitted from September 1997 to September 1998. Characteristics at birth of infants of the two groups (control and hypothermia) were comparable. After obtaining parental consent, whole-body hypothermia was induced before the 6th hour of life by placing a cold blanket (Polar Air, Augustine Medical Inc., model 600) around the body of the patients. Rectal temperature was maintained between 32 and 34°C for 72 h. Outcome was assessed by neurological evaluation at birth and every 3 months up to the 12th month. Brain MRI was performed in the 2nd month. We had no evidence of severe adverse events related to hypothermia. In the hypothermic group there was a significant (p < 0.05) reduction of major neurologic abnormalities at follow-up and abnormal MRI findings. Conclusions: Hypothermia appears to be safe. Our results on morphological damage evaluated by brain MRI and neurological outcome are encouraging: randomized controlled trials are needed to confirm this experience.

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“…Other effects like arrhythmias, coagulation disorders or infections may have long-term sequelae [16±21]. Accidentally cooled prematures with a rectal temperature < 34 C at admission suffered from coagulation disorders, a high incidence of haemorrhage and mortality, while another group of new born prematures with an average rectal temperature of 31 2.7 C at admission exhibited only transient thrombocytopenia and renal failure [18,19].…”

Section: Introductionmentioning

confidence: 99%