ASPHYXIA IN FULL-TERM NEWBORN INFANTS: COMBINATION THERAPY USING CRANIOCEREBRAL HYPOTHERMIA


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Resumo

Objective. To define the role of craniocerebral hypothermia (CCH) in combination therapy for posthypoxic cerebral lesions in children. Subjects and methods. Labor and delivery histories were studied in 46 pregnant women and their babies with birth asphyxia. All the babies underwent CCH in addition to conventional clinical, laboratory, and instrumental studies. Results. There were the following significant risk factors of asphyxia: fat metabolic disturbances, gestosis (preeclampsia), a pathological preliminary period, uterine inertia, premature placental detachment, prolonged pregnancy, and chorioamnionitis. The main causes of asphyxia were umbilical cord abnormalities (41.9%), chronic fetal hypoxia, (25.6%), infection (14.0%), and a combination of these factors and abnormal labor. All the infants survived and they were switched to the second nursing care stage; only 3 (7.0%) babies developed infantile cerebral paralysis (ICP) at the age of 1 year. Conclusion. As compared to conventional therapy, CCHfor babies with birth asphyxia contributes to an increase in the number of healthy infants and to a reduction in the incidence of ICP by 2-2.5 times.

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Sobre autores

Galina Savelyeva

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: gms@cfp.ru
academician RAMS, MD, professor, Head of the department of obstetrics and gynecology, Pediatrics Faculty Moscow 117209, Sevastopolsky pr-t 24a, Russia

Raisa Shalina

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: raisa.shalina@gmail.com
MD, Professor of the department of obstetrics and gynecology Moscow 117209, Sevastopolsky pr-t 24a, Russia

Alexandra Smirnova

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: salexandra2006_0@mail.ru
PhD student of the department of obstetrics and gynecology, Pediatrics Faculty Moscow 117209, Sevastopolsky pr-t 24a, Russia

Janna Kunyah

Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: kunzhan2007@rambler.ru
doctor of the highest category, Head of Intensive care unit for premature and newborn Moscow 117209, Sevastopolsky pr-t 24a, Russia

Olga Evstratova

Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: Evstratola@gmail.com
the physician anesthesiologist, Intensive care unit for premature and newborn Moscow 117209, Sevastopolsky pr-t 24a, Russia

Maria Simuhina

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: msimuhina@gmil.com
clinical intern of the department of obstetrics and gynecology, Pediatrics Faculty Moscow 117209, Sevastopolsky pr-t 24a, Russia

Bibliografia

  1. Суханова Л.П., Скляр М.С. Детская и перинатальная смертность в России: тенденции, структура, факторы риска. Социальные аспекты здоровья населения. 2007; 4.
  2. Кравченко Е.Н., ред. Родовая травма. Акушерские и перинатальные аспекты. М.: ГЭОТАР-Медиа; 2009. 240с.
  3. Polderman K. Inducted hypothermia and fever control for prevention and treatment of neurological injuries. Lancet. 2008; 371(9628): 1955-69.
  4. Adelson P.D., Bratton S.L., Carney N.A., Chesnut R.M., du Coudray H.E., Goldstein B. et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Chapter 14. The role of temperature control following sever pediatric traumatic brain injury. Pediatr. Crit. Care Med. 2003; 4(3, Suppl.): S53-5.
  5. Jacobs S., Hunt R., Tarnow-Mordi W., Inder T., Davis P. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst. Rev. 2007; (4): CD003311.
  6. Papile L.A., Baley J.E., Benitz W., Cummings J., Carlo W.A., Eichenwald E. et al. Hypothermia and neonatal encephalopathy. Pediatrics. 2014; 133(6): 1146-50.
  7. Battin M.R., Thoresen M., Robinson E., Polin R.A., Edwards A.D., Gunn A.J.; Cool Cap Trial Group. Does head cooling with mild systemic hypothermia affect requirement for blood pressure support? Pediatrics. 2009; 123(3): 1031-6.
  8. Fink E.L., Kochanek P.M., Clark R.S., Bell M.J. How I cool children in neurocritical care. Neurocrit. Care. 2010; 12(3): 414-20.
  9. Hoehn T., Hagberg B., Hagberg G., Beckung E., Uvebrant P. Changing panorama of cerebral palsy in Sweden. VIII. Prevalance and origin in the birth year period 1991-94. Acta Paediatr. 2001; 90(3): 271-7.
  10. Eicher D.J., Wangner C.L., Katikaneni L.P. Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr. Neurol. 2005; 32(1): 11-7.
  11. Fairchild K., Sokora D., Scott J., Zanelli S. Therapeutic hypothermia on neonatal transport: 4-year experience in a single NICU. J. Perinatol. 2010; 30(5): 324-9.
  12. Кравченко Е.Н., Башмакова Н.В. Значение интранатальной охраны плода в улучшении перинатальных исходов. Российский вестник акушера-гинеколога. 2008; 8(2): 25-9.
  13. Wayock C.P., Meserole R.L., Saria S., Jennings J.M., Huisman T.A., Norhington F.J., Graham E.M. Perinatal risk factors for severe injury in neonates treated with whole-body hypothermia for encephalopathy. Am. J. Obstet. Gynecol. 2014; 211(1): 41. e1-8.
  14. NelsonD.B., LuckeA.M., MclntireD.D., SanchezP.J., LevenoK.J., ChalakL.F. Obstetric antecedents to body-cooling treatment of the newborn infant. Am. J. Obstet. Gynecol. 2014; 211(2): 155. e1-6.
  15. Nash K.B., Bonifacio S.L., Glass H.C., Sullivan J.E., Barkovich A.J., Ferriero D.M., Cilio M.R. Video-EEG monitoring in newborns with hypoxic- ischemic encephalopathy treated with hypothermia. Neurology. 2011; 76(6): 556-62.
  16. Abend N.S., Mani R., Tschuda T.N., Chang T., Topjian A.A., Donnelly M. et al. EEG monitoring during therapeutic hypothermia in neonates, children, and adults. Am. J. Electroneurodiagnostic Technol. 2011; 51(3): 141-64.
  17. Pisani F., Copioli C., Di Gioia C., Turco E., Sisti L. Neonatal seizures: relation of ictal video-electroencephalography (EEG) findings with neurodevelopmental outcome. J. Child Neurol. 2008; 23(4): 394-8.
  18. Российская ассоциация специалистов перинатальной медицины. Классификация перинатальных поражений нервной системы и их последствий у детей первого года жизни. Методические рекомендации. М.; 2007.
  19. Радзинский В.Е., Костин И.Н., Златовратская Т.В., Котайш Г.А., Фаткуллин И.Ф., Григорьева Е.Е. Доношенные дети, подвергшиеся реанимации. Анализ акушерской тактики. Акушерство и гинекология. 2007; 3: 42-7.
  20. Azzopardi D., Strohm B., Marlow N., Brocklehurst P., Deierl A., Eddama O. et al. Effects of hypothermia for perinatal asphyxia on childhood outcomes. N. Engl. J. Med. 2014; 371(2): 140-9.

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