López AJU

Language: Spanish
References: 16
Page: 133-138
PDF size: 129.78 Kb.

ABSTRACT

Hypoxic-ischemic encephalopathy is an entity in preterm and term newborns, related with perinatal hypoxic or anoxic injury (perinatal asphyxia). They are wide signs and symptoms according the time of hypoxemia or asphyxia, form of presentation and biochemical changes because the lack of oxygen, also the response of the cerebral vessels and the rest of the organs like: heart, lungs, kidney and phenomena of reperfusion. Actually in animal models our knowledge of biochemical changes, and the cerebral processes during ischemia they are proposed diverse therapeutics pointed in this observations. Recently, the goal is to limitate the hypoxic- ischemic injury, by the use of drugs that play an important role in cerebral biochemical phenomena, also, reduce cerebral metabolism, and the recently use of hypothermia, vital support including hemodynamic and biochemical stability, and the use of ventilatory modalities like hypoxemia and hypercapnia permissible. All this proposal therapeutics used alone or in junction gives us an optimistic future.

REFERENCES

1. Vannuci RC. Mechanisms of perinatal hypoxic-ischemic brain damage. Sem Perinatol 1993; 17:330-337.

2. Niermeyer S, Van Reempts P, Kattwinkel Jh, Wiswell Th, Burchfield D, Saugstad OD, Milner A, Knaebel St, et al. Resuscitation of newborns. Ann Emerg Med 2001;31:S110-S125.

3. Jacinto SJ, Gieron-Korthals M, Ferreira JA. Predicting outcome in hypoxic-ischemic brain injury. Ped Clin North Am 2001;3:671-686.

4. Laptook AR., Corbett RJ, Sterett RB, Dennis K, García D, Tollefsbol G. Modest hypothermia provides partial neuroprotection when used for immediate resuscitation after brain ischemia. Pediatr Res 1997;42:17-23.

5. Wagner CL., Eicher DJ, Katikanemi LD, Barbosa E. Holden KR. The use of hypothermia: a role in the treatment of neonatal asphyxia. Pediatr Neurol 1999;21:429-443.

6. Gunn AJ, Gluckm PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study. Pediatrics.1998;102:885-892.

7. Azzopardi D, Robertson NJ, Cowan FM., Rutherford MA, Rampling M, Edwards M. Pilot study of treatment with whole body hypothermia for neonatal encephalopathy. Pediatrics 2000;106:684-694

8. Kochanek PM, Clark RS, Ruppel RA, Dixon CE. Cerebral resuscitation after traumatic brain injury and cardiopulmonary arrest in infants ands children in the new millennium. Ped Clin North Am 2001;3:687-710.

9. Battin MR, Dezoete JA, Gunn TR, Gkluckman PD. Gunn AJ. Neurodevelopment outcome of infants treated with head cooling and mild hypothermia after perinatal asphyxia. Pediatrics 2001;107:480-484.

10. Macaya A. Cell death in neonatal hypoxia-ischemia. Rev Neurol 2000;31:784-9.

11. Wyatt JS, Thoresen M. Hypotermia treatment and the newborn. Pediatrics 1997;100:1028-1030.

12. Thoresen M, Whitelaw A. Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants with hypoxic-ischemic encephalopathy. Pediatrics 2000;106:133-4

13. Thoresen M, Penrice J, Lorek A, Cady EB, Wylezinska M., Kirkbride V, Cooper CE., Brown GC, Edwards AD, WyattJS, Reynolds OR. Mild hypothermia after severe transient hypoxia-ischemia ameliorates delayed cerebral energy failure in the newborn piglet. Pediatr Res 1995;37:667-670.

14. Edwards AD, Wyatt JS, Thoresen M. Treatment of hypoxic-ischemic brain damage by moderate hypothermia. Arch Dis Child Fetal Neonatal 1998;78:85-88

15. Gunn AJ, Gunn TR, Gunning MI, Willians ChE, Gluckman PD. Neuroprotection with prolonged head cooling started before post ischemic seizures in fetal sheep. Pediatrics 1998;102:1098-1106.

16. Aguilar-Rebolledo F. Encefalopatía hipóxico-isquémica. Su manejo y secuelas. En: Avances en la restauración del sistema nervioso. México D.F. DEMSA Editores 2003; 125-140.