Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit

Objective: The objective of this study was to determine the efficacy of mild hypothermia via selective head cooling as a neuroprotective therapy in term infants with perinatal asphyxia. Study design: Full-term newborns who had 5 min Apgar scores

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Veröffentlicht in:Journal of Perinatology 2006-03, Vol.26 (3), p.180-184
Hauptverfasser: Lin, Z-L, Yu, H-M, Lin, J, Chen, S-Q, Liang, Z-Q, Zhang, Z-Y
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container_start_page 180
container_title Journal of Perinatology
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creator Lin, Z-L
Yu, H-M
Lin, J
Chen, S-Q
Liang, Z-Q
Zhang, Z-Y
description Objective: The objective of this study was to determine the efficacy of mild hypothermia via selective head cooling as a neuroprotective therapy in term infants with perinatal asphyxia. Study design: Full-term newborns who had 5 min Apgar scores
doi_str_mv 10.1038/sj.jp.7211412
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Study design: Full-term newborns who had 5 min Apgar scores &lt;6, first arterial blood gas pH&lt;7.10 or BD&gt;15 mEq/l, and with the clinical signs of encephalopathy were enrolled within 6 h after birth. Patients were randomized to receive mild hypothermia treatment via selective head cooling for a total of 72 h or receive routine treatment as a control. Brain hypoxic-ischemic injury was quantified based on the head computed tomographic scan (CT scan) at postnatal age 5–7 days and a Neonatal Behavioral Neurological Assessment (NBNA) score at 7–10 days of life. Results: A total of 58 patients (30 hypothermia, 28 control) completed the study. Hypothermia was well tolerated in this study and attenuated the hypoxic-ischemic brain injury due to perinatal asphyxia. Head CT scan demonstrated moderate to severe hypoxic-ischemic changes in only 4/30 cases from the hypothermic group. In contrast, 18/28 cases in the control group showed moderate to severe hypoxic-ischemic changes ( χ 2 =15.97, P &lt;0.01). Brain hypothermia also significantly improved the NBNA score (32±2 in the hypothermic group vs 28±3 in the control group, P &lt;0.01). Conclusion s: Our results suggest that selective head cooling may be used as a neuroprotective therapy in term neonates with perinatal asphyxia. A long-term follow-up study is needed to further validate the results of this study.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/sj.jp.7211412</identifier><identifier>PMID: 16407967</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Apgar Score ; Asphyxia ; Asphyxia neonatorum ; Asphyxia Neonatorum - diagnosis ; Asphyxia Neonatorum - therapy ; Brain ; Brain damage ; Brain injury ; Care and treatment ; Case-Control Studies ; Complications and side effects ; Computed tomography ; Control ; Cooling ; Diagnosis ; Encephalopathy ; Female ; Follow-Up Studies ; Gestational Age ; Head ; Head injuries ; Humans ; Hypothermia ; Hypothermia, Induced - methods ; Hypoxia ; Hypoxia, Brain - prevention &amp; control ; Infant, Newborn ; Intensive Care Units, Neonatal ; Ischemia ; Male ; Medical imaging ; Medicine ; Medicine &amp; Public Health ; Neonates ; Neuroprotection ; Newborn babies ; original-article ; Patients ; Pediatric Surgery ; Pediatrics ; Pregnancy ; Prognosis ; Reference Values ; Risk Assessment ; Risk factors ; Sensitivity and Specificity ; Severity of Illness Index ; Suffocation ; Survival Rate ; Therapy ; Treatment Outcome</subject><ispartof>Journal of Perinatology, 2006-03, Vol.26 (3), p.180-184</ispartof><rights>Springer Nature America, Inc. 2006</rights><rights>COPYRIGHT 2006 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Mar 2006</rights><rights>Nature Publishing Group 2006.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c537t-e0e407b3697e88ab426475ef00135292c5b9ce1e1c3c39b61ed2254bd121b93b3</citedby><cites>FETCH-LOGICAL-c537t-e0e407b3697e88ab426475ef00135292c5b9ce1e1c3c39b61ed2254bd121b93b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sj.jp.7211412$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sj.jp.7211412$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16407967$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Z-L</creatorcontrib><creatorcontrib>Yu, H-M</creatorcontrib><creatorcontrib>Lin, J</creatorcontrib><creatorcontrib>Chen, S-Q</creatorcontrib><creatorcontrib>Liang, Z-Q</creatorcontrib><creatorcontrib>Zhang, Z-Y</creatorcontrib><title>Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit</title><title>Journal of Perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>Objective: The objective of this study was to determine the efficacy of mild hypothermia via selective head cooling as a neuroprotective therapy in term infants with perinatal asphyxia. Study design: Full-term newborns who had 5 min Apgar scores &lt;6, first arterial blood gas pH&lt;7.10 or BD&gt;15 mEq/l, and with the clinical signs of encephalopathy were enrolled within 6 h after birth. Patients were randomized to receive mild hypothermia treatment via selective head cooling for a total of 72 h or receive routine treatment as a control. Brain hypoxic-ischemic injury was quantified based on the head computed tomographic scan (CT scan) at postnatal age 5–7 days and a Neonatal Behavioral Neurological Assessment (NBNA) score at 7–10 days of life. Results: A total of 58 patients (30 hypothermia, 28 control) completed the study. Hypothermia was well tolerated in this study and attenuated the hypoxic-ischemic brain injury due to perinatal asphyxia. Head CT scan demonstrated moderate to severe hypoxic-ischemic changes in only 4/30 cases from the hypothermic group. 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Study design: Full-term newborns who had 5 min Apgar scores &lt;6, first arterial blood gas pH&lt;7.10 or BD&gt;15 mEq/l, and with the clinical signs of encephalopathy were enrolled within 6 h after birth. Patients were randomized to receive mild hypothermia treatment via selective head cooling for a total of 72 h or receive routine treatment as a control. Brain hypoxic-ischemic injury was quantified based on the head computed tomographic scan (CT scan) at postnatal age 5–7 days and a Neonatal Behavioral Neurological Assessment (NBNA) score at 7–10 days of life. Results: A total of 58 patients (30 hypothermia, 28 control) completed the study. Hypothermia was well tolerated in this study and attenuated the hypoxic-ischemic brain injury due to perinatal asphyxia. Head CT scan demonstrated moderate to severe hypoxic-ischemic changes in only 4/30 cases from the hypothermic group. In contrast, 18/28 cases in the control group showed moderate to severe hypoxic-ischemic changes ( χ 2 =15.97, P &lt;0.01). Brain hypothermia also significantly improved the NBNA score (32±2 in the hypothermic group vs 28±3 in the control group, P &lt;0.01). Conclusion s: Our results suggest that selective head cooling may be used as a neuroprotective therapy in term neonates with perinatal asphyxia. A long-term follow-up study is needed to further validate the results of this study.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>16407967</pmid><doi>10.1038/sj.jp.7211412</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings
subjects Apgar Score
Asphyxia
Asphyxia neonatorum
Asphyxia Neonatorum - diagnosis
Asphyxia Neonatorum - therapy
Brain
Brain damage
Brain injury
Care and treatment
Case-Control Studies
Complications and side effects
Computed tomography
Control
Cooling
Diagnosis
Encephalopathy
Female
Follow-Up Studies
Gestational Age
Head
Head injuries
Humans
Hypothermia
Hypothermia, Induced - methods
Hypoxia
Hypoxia, Brain - prevention & control
Infant, Newborn
Intensive Care Units, Neonatal
Ischemia
Male
Medical imaging
Medicine
Medicine & Public Health
Neonates
Neuroprotection
Newborn babies
original-article
Patients
Pediatric Surgery
Pediatrics
Pregnancy
Prognosis
Reference Values
Risk Assessment
Risk factors
Sensitivity and Specificity
Severity of Illness Index
Suffocation
Survival Rate
Therapy
Treatment Outcome
title Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit
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