본문 바로가기
KERD
논문KCI 등재

Initiation of Therapeutic Hypothermia with a Cooling Fan for an Asphyxiated Newborn

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Induced hypothermia for newborns with hypoxic-ischemic encephalopathy results in a significant decrease in mortality and neurodevelopmental disability. For optimal neuroprotection following perinatal hypoxia-ischemia (HI), therapy should begin within 6 hrs of the insult and continue for ≥72 hrs. We report on a baby with HI who underwent therapeutic hypothermia that was initiated with a cooling fan, as the whole-body cooling machine was in use for another patient. Although overcooling occurred, the method was successful. For effective and safe brain hypothermic therapy (BHT), a purpose-built cooling machine is recommended. The adherence to standard protocol is required for every BHT, as clearly defined by protocols similar to those used in published trials.

Abstract

Induced hypothermia for newborns with hypoxic-ischemic encephalopathy results in a significant decrease in mortality and neurodevelopmental disability. For optimal neuroprotection following perinatal hypoxia-ischemia (HI), therapy should begin within 6 hrs of the insult and continue for ≥72 hrs. We report on a baby with HI who underwent therapeutic hypothermia that was initiated with a cooling fan, as the whole-body cooling machine was in use for another patient. Although overcooling occurred, the method was successful. For effective and safe brain hypothermic therapy (BHT), a purpose-built cooling machine is recommended. The adherence to standard protocol is required for every BHT, as clearly defined by protocols similar to those used in published trials.

참고문헌 (21)

  1. Shankaran S, "Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy", N Engl J Med, 353, pp.1574~1584 (2005)
  2. Kattwinkel J, "Part 15: neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care", Circulation, 122, pp.909~919 (2010)
  3. Gunn AJ, "Hypothermic neuroprotection", NeuroRx, 3, pp.154~169 (2006)
  4. Robertson NJ, "Therapeutic hypothermia for birth asphyxia in lowresource settings: a pilot randomised controlled trial", Lancet, 372, pp.801~803 (2008)
  5. Horn A, "Induced hypothermia for infants with hypoxic- ischemic encephalopathy using a servo-controlled fan: an exploratory pilot study", Pediatrics, 123, pp.e1090~e1098 (2009)
  6. Jacobs S, "Cooling for newborns with hypoxic ischaemic encephalopathy", Cochrane Database Syst Rev, (4), pp.003311~ (2007)
  7. Iwata O, ""Therapeutic time window" duration decreases with increasing severity of cerebral hypoxia-ischaemia under normothermia and delayed hypothermia in newborn piglets", Brain Res, 1154, pp.173~180 (2007)
  8. Fairchild K, "Therapeutic hypothermia on neonatal transport: 4-year experience in a single NICU", J Perinatol, 30, pp.324~329 (2010)
  9. Kerenyi A, "Systemic effects of whole-body cooling to 35℃, 33.5℃, and 30℃ in a piglet model of perinatal asphyxia: implications for therapeutic hypothermia", Pediatr Res, 71, pp.573~582 (2012)
  10. Sant'Anna G, "Phenobarbital and temperature profile during hypothermia for hypoxic-ischemic encephalopathy", J Child Neurol, 27, pp.451~457 (2012)
  11. Badjatia N, "Metabolic benefits of surface counter warming during therapeutic temperature modulation", Crit Care Med, 37, pp.1893~1897 (2009)
  12. Bhat MA, "Magnesium sulfate in severe perinatal asphyxia: a randomized, placebo-controlled trial", Pediatrics, 123, pp.e764~e769 (2009)
  13. Lasky RE, "Changes in the PQRST intervals and heart rate variability associated with rewarming in two newborns undergoing hypothermia therapy", Neonatology, 96, pp.93~95 (2009)
  14. Lebiedz P, "Electrocardiographic changes during therapeutic hypothermia", Resuscitation, 83, pp.602~606 (2012)
  15. Gluckman PD, "Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial", Lancet, 365, pp.663~670 (2005)
  16. Azzopardi DV, "Moderate hypothermia to treat perinatal asphyxial encephalopathy", N Engl J Med, 361, pp.1349~1358 (2009)
  17. Spitzmiller RE, "Amplitudeintegrated EEG is useful in predicting neurodevelopmental outcome in full-term infants with hypoxic-ischemic encephalopathy: a metaanalysis", J Child Neurol, 22, pp.1069~1078 (2007)
  18. Shankaran S, "Ehrenkranz RA, et al. Predictive value of an early amplitude integrated electroencephalogram and neurologic examination", Pediatrics, 128, pp.e112~e120 (2011)
  19. Hallberg B, "The prognostic value of early aEEG in asphyxiated infants undergoing systemic hypothermia treatment", Acta Paediatr, 99, pp.531~536 (2010)
  20. Gucuyener K, "Use of amplitude-integrated electroencephalography (aEEG) and near infrared spectroscopy findings in neonates with asphyxia during selective head cooling", Brain Dev, 34, pp.280~286 (2012)
  21. Iwata O, "Hypothermia for neonatal encephalopathy: Nationwide Survey of Clinical Practice in Japan as of August 2010", Acta Paediatr, 101, pp.e197~e202 (2012)

이 간행물의 다른 논문 (13건)