Early Glycemic Profile Is Associated with Brain Injury Patterns on Magnetic Resonance Imaging in Hypoxic Ischemic Encephalopathy
Sudeepta K. BasuKatherine M. OttoliniVedavalli GovindanSuleiman MashatGilbert VézinaYunfei WangMichaelande RidoreTaeun ChangJeffrey R. KaiserAn N. Massaro
37
Citation
32
Reference
10
Related Paper
Citation Trend
Keywords:
Hypoxic-Ischemic Encephalopathy
Neonatal hypoglycemia
Brain damage
Neonatal Encephalopathy
Moderate to severe hypoxic–ischemic injury in newborn infants, manifested as encephalopathy immediately or within hours after birth, is associated with a high risk of either death or a lifetime with disability. In recent multicenter clinical trials, hypothermia initiated within the first 6 postnatal hours has emerged as a therapy that reduces the risk of death or impairment among infants with hypoxic–ischemic encephalopathy. Prior to hypothermia, no therapies directly targeting neonatal encephalopathy secondary to hypoxic–ischemic injury had convincing evidence of efficacy. Hypothermia therapy is now becoming increasingly available at tertiary centers. Despite the deserved enthusiasm for hypothermia, obstetric and neonatology caregivers, as well as society at large, must be reminded that in the clinical trials more than 40% of cooled infants died or survived with impairment. Although hypothermia is an evidence-based therapy, additional discoveries are needed to further improve outcome after HIE. In this article, we briefly present the epidemiology of neonatal encephalopathy due to hypoxic–ischemic injury, describe the rationale for the use of hypothermia therapy for hypoxic–ischemic encephalopathy, and present results of the clinical trials that have demonstrated the efficacy of hypothermia. We also present findings noted during and after these trials that will guide care and direct research for this devastating problem.
Hypoxic-Ischemic Encephalopathy
Neonatal Encephalopathy
Neonatology
Cite
Citations (90)
Hypoglycemia is a common metabolic disorder of neonates.It is also one of the controversial issues among neonatologists.The focuses of controversy include the definition of hypoglycemia,associated brain damage,the threshold value of treatment,and long-term prognosis.These issues have led to improvements in obstetric and neonatal care.However,Brain damage caused by hypoglycemia is still occurred frequently.Although the tolerance to hypoglycemia in premature brain is better than in mature brain,the risk of brain damage is increased when hypoglycemia is persistent or recurrent,and or accompanied by other risk events such as hypoxia-ischemia convulsions.,Serious and persistent hypoglycemia can damage not only the neurons in the cerebral cortex,but also the glial cells in the subcortical white matter,particularly in occipitoparietal the region.The common neurological sequelae include cerebral palsy,mental retardation,visual disturbance,convulsions and microcephaly.Thus,although the value of blood glucose for diagnostic criteria for neonatal hypoglycemia is less than 2.2 mmol / L(40 mg/dL),the thresholds of blood glucose for prevention is defined as 2.6 mmol / L(45 ~ 50 mg/dL).
Neonatal hypoglycemia
Brain damage
Microcephaly
Hypoxia
Cite
Citations (0)
hypoxic-ischemic encephalopathyas a standard term has been used for over 30 years, but now increasingly being questioned.Most experts recommend usingneonatal encephalopathyinstead ofhypoxic-ischemic encephalopathy. The American College of Obstetricians and Gynecologists and The American Academy of Pediatrics published separately the report of Task Force on Neonatal EncephalopathyNeonatal Encephalopathy and Neurologic Outcome, Second Editionin 2014.Definition, diagnosis and treatment ofneonatal encephalopathyand other content have been updated in the report.It is recommended that a comprehensive multidimensional assessment be performed of neonatal encephalopathy.This article will introduce the controversy aboutneonatal encephalopathyorhypoxic-ischemic encephalopathyand contents of the report of Task Force on Neonatal Encephalopathy.
Key words:
Newborn; Neonatal encephalopathy; Hypoxic ischemic encephalopathy
Task force
Hypoxic-Ischemic Encephalopathy
Neonatal Encephalopathy
Cite
Citations (0)
Neonatal Encephalopathy
Neonatal hypoglycemia
Cite
Citations (157)
Hypoxic-Ischemic Encephalopathy
Neonatal Encephalopathy
Etiology
Brain damage
Cite
Citations (20)
Hypoxic-Ischemic Encephalopathy
Neonatal Encephalopathy
Hypoxia
Cite
Citations (78)
Due to the fact that early full term newborn has no specific clinical signs,early diagnosis of hypoxic-ischemic brain damage is difficult. Timely intervention will affect the longterm prognosis in patients with the treatment and survival. Amplitude integrated electroencephalography（ aEEG） is a noninvasive monitoring and evaluation of brain function,simple and effective method,which can provide exact basis for full term newborn with hypoxic ischemic brain damage in early diagnosis and prediction of prognosis.
Key words:
Amplitude integrated electroencephalography; Hypoxic-ischemic encephalopathy; Early diagnosis; Evaluation of prognosis; Neonate
Hypoxic-Ischemic Encephalopathy
Brain damage
Brain Function
Hypoxia
Full Term
Cite
Citations (0)
Neonatal Encephalopathy
Hypoxic-Ischemic Encephalopathy
Neonatal seizure
Hypoxia
Cite
Citations (1)
Objective To analyse the clinical features of neonatal hypoglycemia brain damage.Methods The clinical data of 40 children with hypoglycemia were analysed retrospectivly.Results Brain damage group than non-brain injury group in the duration of hypoglycemia,recurrent episodes12h and neonatal seizures(P0.01).After 24h of treatment,blood glucose returned to normal in non-brain injury group than that in brain damage group(P0.01).Conclusion Neonatal hypoglycemic brain damage must be early detection and prevention.
Brain damage
Neonatal hypoglycemia
Cite
Citations (0)
Objective To analyze the neonatal blood glucose level with the correlation between the occurrence of hypoxicischemic encephalopathy brain damage.Methods In our hospital from May 2011 to April 2012,40 cases with HIE were divided into normal group and hypoglycemia group,according to the blood sugar levels,each group had 20 cases.To moni toring blood glucose of children,and dynamically observe the time of children's brain damage symptoms disappeared and its Gesell Act smart rated.Results The average time of symptoms disappearing of the hypoglycemia group was significantly higher than the normal group(P 0.05).In addition,the Gesell Act Smart Ratings of hypoglycemia group was significant ly lower than the normal group(P 0.05).Conclusion Low blood sugar can aggravate HIE brain damage,and promptly correct the hypoglycemia can reduce the degree of HIE brain damage and also reduce the incidence of cerebral palsy.
Brain damage
Neonatal hypoglycemia
Blood sugar
Hypoxic-Ischemic Encephalopathy
Cite
Citations (0)