Asphyxiated Infants (asphyxiated + infant)

Distribution by Scientific Domains

Selected Abstracts

Is serum troponin T a useful marker of myocardial damage in newborn infants with perinatal asphyxia?

S. Costa
Abstract Aim: To assess the correlation of echocardiographic signs of myocardial damage to serum cardiac troponin T (cTnT) concentrations in newborn infants with perinatal asphyxia. Methods: Electocardiograms (ECG) and echocardiograms (Echo) were obtained during the first 24 h of life from 29 asphyxiated and 30 control infants and correlated with cTnT concentrations. The echocardiographic parameters included systolic ventricular performance, preload, afterload, diastolic function, stroke volume (SV), left ventricular output (LVO), hyperechogenity of the papillary muscles and insufficiency of the atrioventricular valves. Results: LVO and SV were lower but CTnT were significantly higher in asphyxiated than in control infants: 0.15 (010,0.23) vs. 0.05 (0.02,0.13), p < 0.001). Asphyxiated infants with signs of myocardial damage were associated with significantly higher cTnT than those without, 0.20 (0.11,0.28) and 0.11 (0.05,0.14 ug/L), p = 0.04. Conclusion: Cardiac troponin may prove to be valuable in evaluating myocardial damage in birth asphyxia. However, the degree of prematurity may complicate the assessment. [source]

Clinical experience with therapeutic hypothermia in asphyxiated infants

Andrew Whitelaw
No abstract is available for this article. [source]

The prognostic value of early aEEG in asphyxiated infants undergoing systemic hypothermia treatment

B Hallberg
Abstract Background:, Induced moderate hypothermia (HT) for 72 h has been shown to reduce the combined outcome of death or severe neurodevelopmental disabilities in asphyxiated full-term infants. A pathological amplitude integrated EEG background as early as 3,6 h after birth, has been shown to correlate to poor prognosis. Aim:, The aim of this study was to investigate the correlation between amplitude integrated EEG during HT treatment and short-term outcome in asphyxiated full-term infants with moderate/severe hypoxic-ischaemic encephalopathy. Methods:, Between December 2006 and December 2007, 24 infants were treated with moderate HT (33.5C for 72 h) using a cooling mattress. Motor functions were assessed at 4 and 12 months of age. Results:, Of the total birth cohort of 28,837 infants, 26 infants fulfilled the criteria for HT treatment (0.9/1000) of whom 23 was treated with HT and all of these infants had available amplitude integrated EEG data. Normal 1-year outcome was found in 10/15 infants with severely abnormal burst-suppression pattern or worse at 6 h of age. Severe abnormalities were found to be significantly predictive for abnormal outcome after 36 h. Conclusion:, Among asphyxiated infants treated with HT, only those who had aEEG abnormalities persisting at and beyond 24 h after birth showed poor neurological outcome at 1 year. [source]

Passive induction of hypothermia during transport of asphyxiated infants: a risk of excessive cooling

Boubou Hallberg
Abstract Background: Induced mild hypothermia is an emerging therapy that has been shown to reduce the combined outcome of death or severe neurodevelopmental disabilities in asphyxiated full-term infants if started within 6 h after birth. Aim: To study the feasibility and safety of inducing hypothermia in asphyxiated infants already at the referring hospital by stopping active warming. Methods: Temperatures during passive induction of hypothermia were prospectively collected from transported asphyxiated infants. Results: Between December 2006 and April 2008, 37 infants of the total birth cohort of 40 350 fulfilled the criteria for hypothermia treatment. Eighteen of 34 infants treated with induced hypothermia were outborn. The rectal temperatures of the infants were 33.0,36.4C before transport and 31.0,36.5C on arrival. Six of the infants had a sub-therapeutic (<33.0C) rectal temperature on arrival. Conclusion: Passive induction of hypothermia by turning off active warming devices is possible, making an earlier start of hypothermia achievable. However, there is a substantial risk of unintended excessive cooling; therefore, continuous monitoring of the central temperature is mandatory when such a strategy is used. [source]

Low cerebral blood flow velocity and head circumference in infants with severe hypoxic ischemic encephalopathy and poor outcome

Pilvi Ilves
Abstract Aims: To evaluate long-term changes in cerebral blood flow velocity (CBFV) and head circumference in asphyxiated infants. Methods: CBFV was measured in 83 asphyxiated and 115 healthy term infants in anterior and middle cerebral, basilar and internal carotid artery (ICA) up to the age of 60,149 days. The psychomotor development and head circumference was followed for 18 months. Results. Mean CBFV was increased (p < 0.05) during the first days after asphyxia in infants with severe hypoxic-ischemic encephalopathy (HIE) (n = 25) compared to control group or infants with mild to moderate HIE (n = 58) with maximum values found at the age of 36,71.9 h: in ICA (mean [95% CI]) 31.2 (25.5,36.6) cm/s in severe HIE infants compared to 13.0 (12.2,13.9) cm/s in controls. Decreased (p < 0.0001) mean CBFV developed in severe HIE infants by the age of 21,59 days: in ICA 14.1 (11.5,16.8) cm/s compared to 22.9 (21.4,24.4) cm/s in controls. Infants with severe HIE had similar mean height but lower head circumferences compared to controls (p < 0.05) at the age of 21,59 days. Conclusion: The high mean CBFV found in infants with severe HIE during the first days after asphyxia is temporary and low CBFV and head circumference develops by the age of 21,59 days. [source]