Top

Published in:

01-09-2023

Therapeutic Hypothermia in a Tertiary Reference Center of Rio de Janeiro

Authors: Eduardo Jorge Custódio da Silva, Maria Eduarda Ragghiante Ferreira, Eduardo Jose Berardo Zaeyen, Sheila Mariah de Sá Finni Prado Chaves, Lucia Helena Wagner, Jose Luiz Muniz Bandeira Duarte

Published in: Current Pediatrics Reports | Issue 3/2023

Abstract

Purpose of Review

The study aims to show how the use of therapeutic hypothermia can provide neurological protection to asphyxiated newborns, as we evaluated 56 children in a tertiary-care teaching hospital in the state of Rio de Janeiro.

Recent Finding

Implementing hypothermia protocol in asphyxiated newborns can reduce asphyxia morbidity and mortality in developing countries, such as Brazil. This technique improves the quality of life of a significant number of infants.

Summary

Approximately 3 in every 1000 full-term births suffer with perinatal asphyxia, one of the main causes of hypoxic-ischemic encephalopathy (HIE) in newborns, which has a significant mortality range. Between survivors of perinatal asphyxia, 25 to 30% have cerebral paralysis as the most important sequelae, in addition to mental retardation, learning deficits to varying degrees, and epilepsy. The use of therapeutic hypothermia protocol in asphyxiated newborns will positively affect neurodevelopment, reducing damages and helping repair functions that asphyxia might have caused.

Available only for authorised users

Kurinczuk JJ, White-Koning M, Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. Early Hum Dev. 2010;86:329–38. https://doi.org/10.1016/j.earlhumdev.2010.05.010.CrossRefPubMed

Lawn JE, Lee AC, Kinney M, Sibley L, Carlo WA, Paul VK, et al. Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done? Int J Gynaecol Obstet. 2009;107(Suppl 1):S5-18, S19.CrossRefPubMed

http://svs.aids.gov.br/dantps/centrais-de-conteudos/paineis-demonitoramento/mortalidade/infantil-e-fetal. Accessed 07 Aug 2018.

Martin-Ancel A, Garcia-Alix A, Gaya F, et al. Multiple organ involvement in perinatal asphyxia. J Pediatr. 1995;127:786–93.CrossRefPubMed

Darmstadt GL, Shiffman J, Lawn JE. Advancing the newborn and stillbirth global agenda: priorities for the next decade. ArchDisChild. 2015;100(Suppl 1):S13–8.

Strohm B, Azzopardi D, UK TOBY. Cooling Register Study Group. Temperature control during therapeutic moderate whole-body hypothermia for neonatal encephalopathy. Archs Dis ChildhFetal Neonatal Ed. 2010;95:F373–5.CrossRef

Montaldo P, Pauliah SS, Lally PJ, Oslon L, Thayyil S. Cooling in a low-resource environment: lost in translation. Semin Fetal Neonatal Med. 2015;20:72–9.CrossRefPubMed

Saliba E, Fakhri N, Debillon T. Establishing a hypothermia service for infants with suspected hypoxic-ischemic encephalopathy. Semin Fetal Neonatal Med. 2015;20:80–6.CrossRefPubMed

• Tagin MA, Woolcott CG, Vincer MJ, Whyte RK, Stinson DA. Hypothermia for neonatal hypoxic ischemic encephalopathy: an updated systematic review and meta-analysis. Arch PediatrAdolesc Med. 2012;166:558–66. (Classic article on the subject.)

10.

Ballot DE, Ramdin TD, Bandini RM, Nakwa F, Velaphi S, Coetzee M, Masemola K, Kali GJD, Horn AR, Pillay S, Van Rensburg J, Pepper MS. Therapeutic hypothermia for neonatal hypoxic ischaemic encephalopathy should not be discontinued in low- and middle-income countries. S Afr Med J. 2021;111(12):1168–9. https://doi.org/10.7196/SAMJ.2021.v111i12.16180.CrossRefPubMed

11.

Weng B, Yan C, Chen Y, Gong X, Cai C. Efficiency evaluation of neuroprotection for therapeutic hypothermia to neonatal hypoxic-ischemic encephalopathy. Front Neurosci. 2021;15:668909. https://doi.org/10.3389/fnins.2021.668909.CrossRefPubMedPubMedCentral

12.

• Mathew JL, Kaur N, Dsouza JM. Therapeutic hypothermia in neonatal hypoxic encephalopathy: a systematic review and meta-analysis. J Glob Health. 2022;9(12):04030. https://doi.org/10.7189/jogh.12.04030. (Review article with meta-analysis on the topic.)CrossRef

13.

Thompson CM, Puterman AS, Linley LL, Hann FM, van der Elst CW, Molteno CD, et al. The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome. Acta Paediatr. 1997;86:757–61. https://doi.org/10.1111/j.1651-2227.1997.tb08581. (Review articles. J. Pediatr. (Rio J.) 91 (6 Suppl 1), Nov-Dec 2015. 10.1016/j.jped.2015.07.004).CrossRefPubMed

14.

•• Silveira RC, Procianoy RS. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J Pediatr (Rio J). 2015;91(6 Suppl 1):S78–83. https://doi.org/10.1016/j.jped.2015.07.004. An experience with therapeutic hypothermia in Brazil.

15.

•• Magalhães M, Rodrigues FP, Chopard MR, Melo VC, Melhado A, Oliveira I, Gallacci CB, Pachi PR, Lima Neto TB. Neuroprotective body hypothermia among newborns with hypoxic ischemic encephalopathy: threeyear experience in a tertiary university hospital. A retrospective observational study. Sao Paulo Med J. 2015;133(4):314–9. https://doi.org/10.1590/1516-3180.2013.7740026. An experience with therapeutic hypothermia in Brazil.

16.

Torre Monmany N, Maya Gallego S, EsclapésGiménez T, Sardà Sánchez M, Rodríguez Losada O, Martínez Planas A, OllerFradera O, Alarcón A, Esteban E. Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia. AnPediatr (Engl Ed). 2021;95(6):459–66. https://doi.org/10.1016/j.anpede.2021.07.005.CrossRef

17.

Rennie JM, de Vries LS, Blennow M, et al. ArchDisChild Fetal Neonatal Ed 2019;104:F493–F501.

18.

Bruns N, Blumenthal S, Meyer I, Klose-Verschuur S, Felderhoff-Müser U, Müller H. Application of an Amplitude-integrated EEG monitor (Cerebral Function Monitor) to neonates. J Vis Exp. 2017;(127):55985. https://doi.org/10.3791/55985.

19.

Variane GF, Magalhães M, Gasperine R, Alves HC, Scoppetta TL, Figueredo RJ, et al. Early amplitude-integrated electroencephalography for monitoring neonates at high risk for brain injury. J Pediatr (Rio J). 2017;93:460–6.CrossRefPubMed

20.

Rennie JM, de Vries LS, Blennow M, et al. Characterisation of neonatal seizures and their treatment using continuous EEG monitoring: a multicenter experience. ArchDisChild Fetal Neonatal Ed. 2019;104:F493–501.CrossRef

21.

Vesoulis ZA, Mintzer JP, Chock VY. Neonatal NIRS monitoring: recommendations for data capture and review of analytics. J Perinatol. 2021;41(4):675–88. https://doi.org/10.1038/s41372-021-00946-6.CrossRefPubMedPubMedCentral

22.

• Lally PJ, Montaldo P, Oliveira V, Soe A, Swamy R, Bassett P, Mendoza J, Atreja G, Kariholu U, Pattnayak S, Sashikumar P, Harizaj H, Mitchell M, Ganesh V, Harigopal S, Dixon J, English P, Clarke P, Muthukumar P, Satodia P, Wayte S, Abernethy LJ, Yajamanyam K, Bainbridge A, Price D, Huertas A, Sharp DJ, Kalra V, Chawla S, Shankaran S, Thayyil S; MARBLE consortium. Magnetic resonance spectroscopy assessment of brain injury after moderate hypothermia in neonatal encephalopathy: a prospective multicentre cohort study. Lancet Neurol. 2019;18(1):35–45. https://doi.org/10.1016/S1474-4422(18)30325-9. Classic article on the subject.

23.

Bach AM, Fang AY, Bonifacio S, Rogers EE, Scheffler A, Partridge JC, Xu D, Barkovich AJ, Ferriero DM, Glass HC, Gano D. Early magnetic resonance imaging predicts 30-month outcome safter therapeutic hypothermia for neonatal encephalopathy. J Pediatr. 2021;238:94-101.e1. https://doi.org/10.1016/j.jpeds.2021.07.003.CrossRefPubMed

Title: Therapeutic Hypothermia in a Tertiary Reference Center of Rio de Janeiro
Authors: Eduardo Jorge Custódio da Silva
Maria Eduarda Ragghiante Ferreira
Eduardo Jose Berardo Zaeyen
Sheila Mariah de Sá Finni Prado Chaves
Lucia Helena Wagner
Jose Luiz Muniz Bandeira Duarte
Publication date: 01-09-2023
Publisher: Springer US
Published in: Current Pediatrics Reports / Issue 3/2023
Electronic ISSN: 2167-4841
DOI: https://doi.org/10.1007/s40124-023-00289-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Therapeutic Hypothermia in a Tertiary Reference Center of Rio de Janeiro

Abstract

Purpose of Review

Recent Finding

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Finding

Summary

Please log in to get access to this content

Other articles of this Issue 3/2023

Confidential Telehealth Care for Adolescents: Challenges and Solutions Identified During the COVID-19 Pandemic

Pediatric Nephrology in Low Resource Countries — Challenges and Opportunities

The Medical, Mental, and Social Impacts on Adolescents from the COVID-19 Pandemic

Youth Sexual Exploitation in Nigeria: Pathway Influencers and Crossroad Solutions for an Undercarpet Menace

ECMO Considerations in the Pediatric Cardiac Population