Vol 83, No 3 (2012)
ARTICLES
Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy
Ewa Gulczyńska, Janusz Gadzinowski
Vol 83, No 3 (2012)
ARTICLES
Abstract
Hypoxia-ischemia in the perinatal period is a serious condition affecting infants, which can result in death and cerebral palsy and associated disabilities. There has been significant research progress in hypoxic-ischemic encephalopathy over the last 2 decades. Many new molecular mechanisms of asphyxia have been identified. Despite all these advances, therapeutic interventions in HIE remain to be limited. Recently it has been revealed that mild therapeutic hypothermia is the only modality shown to improve neurologic outcome. The authors present a summary of pathogenesis of HIE, animal studies of cooling for hypoxic and ischemic models, and first publications on human therapeutic hypothermia trials. The diagnosis of encephalopathy in full-term neonates and enrollment criteria for hypothermia are also discussed. The current data from randomized control trials of hypothermia as neuroprotection for full and near-term infants are presented along with the results of metaanalyses of these trials. Finally, the status of ongoing neonatal hypothermia trials as well as status of therapeutic hypothermia in Poland is summarized.
Abstract
Hypoxia-ischemia in the perinatal period is a serious condition affecting infants, which can result in death and cerebral palsy and associated disabilities. There has been significant research progress in hypoxic-ischemic encephalopathy over the last 2 decades. Many new molecular mechanisms of asphyxia have been identified. Despite all these advances, therapeutic interventions in HIE remain to be limited. Recently it has been revealed that mild therapeutic hypothermia is the only modality shown to improve neurologic outcome. The authors present a summary of pathogenesis of HIE, animal studies of cooling for hypoxic and ischemic models, and first publications on human therapeutic hypothermia trials. The diagnosis of encephalopathy in full-term neonates and enrollment criteria for hypothermia are also discussed. The current data from randomized control trials of hypothermia as neuroprotection for full and near-term infants are presented along with the results of metaanalyses of these trials. Finally, the status of ongoing neonatal hypothermia trials as well as status of therapeutic hypothermia in Poland is summarized.
Keywords
newborn, selective head cooling, whole body cooling, hypoxic-ischemic encephalopathy
Title
Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy
Journal
Ginekologia Polska
Issue
Vol 83, No 3 (2012)
Page views
1388
Article views/downloads
4897
Bibliographic record
Ginekol Pol 2012;83(3).
Keywords
newborn
selective head cooling
whole body cooling
hypoxic-ischemic encephalopathy
Authors
Ewa Gulczyńska
Janusz Gadzinowski
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