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Redox Biology Aug 2017Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen... (Review)
Review
Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes. In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage. Hence, clinical trials have shown that the use of 100% oxygen given with positive pressure in the airways of the newborn infant during resuscitation causes more oxidative stress than using air, and increases mortality. Preterm infants are endowed with an immature lung and antioxidant system. Clinical stabilization of preterm infants after birth frequently requires positive pressure ventilation with a gas admixture that contains oxygen to achieve a normal heart rate and arterial oxygen saturation. In randomized controlled trials the use high oxygen concentrations (90% to 100%) has caused more oxidative stress and clinical complications that the use of lower oxygen concentrations (30-60%). A correlation between the amount of oxygen received during resuscitation and the level of biomarkers of oxidative stress and clinical outcomes was established. Thus, based on clinical outcomes and analytical results of oxidative stress biomarkers relevant changes were introduced in the resuscitation policies. However, it should be underscored that analysis of oxidative stress biomarkers in biofluids has only been used in experimental and clinical research but not in clinical routine. The complexity of the technical procedures, lack of automation, and cost of these determinations have hindered the routine use of biomarkers in the clinical setting. Overcoming these technical and economical difficulties constitutes a challenge for the immediate future since accurate evaluation of oxidative stress would contribute to improve the quality of care of our neonatal patients.
Topics: Asphyxia Neonatorum; Female; Humans; Infant, Newborn; Infant, Premature; Lipid Peroxidation; Oxidative Stress; Oxygen; Resuscitation
PubMed: 28395175
DOI: 10.1016/j.redox.2017.03.011 -
British Medical Journal Aug 1953
Topics: Asphyxia; Asphyxia Neonatorum; Humans; Infant, Newborn
PubMed: 13059490
DOI: No ID Found -
Clinics in Perinatology Sep 2016Although therapies in addition to whole-body cooling are being developed to treat the neonate at risk for hypoxic-ischemic encephalopathy, we have no quickly measured... (Review)
Review
Although therapies in addition to whole-body cooling are being developed to treat the neonate at risk for hypoxic-ischemic encephalopathy, we have no quickly measured serum inflammatory or neuronal biomarkers to acutely and accurately identify brain injury or to follow the efficacy of therapy. This review covers inflammatory serum biomarkers in the setting of birth asphyxia that can help assess the degree or severity of encephalopathy at birth and neurodevelopmental outcomes. These biomarkers still need to be independently validated in large cohorts before they are ready for clinical implementation in practice.
Topics: Asphyxia Neonatorum; Biomarkers; Cytokines; Female; Glial Fibrillary Acidic Protein; Humans; Hypoxia-Ischemia, Brain; Infant, Newborn; Inflammation; Phosphopyruvate Hydratase; Placenta; Pregnancy; S100 Calcium Binding Protein beta Subunit; Ubiquitin Thiolesterase
PubMed: 27524450
DOI: 10.1016/j.clp.2016.04.008 -
Gaceta Sanitaria 2021This study aims to determine the risk factors of asphyxia neonatorum in two PONED Public Health Centers of Nosarara and Pantoloan, in Palu City, Central Sulawesi.
OBJECTIVE
This study aims to determine the risk factors of asphyxia neonatorum in two PONED Public Health Centers of Nosarara and Pantoloan, in Palu City, Central Sulawesi.
METHODS
This study used a case-control study design. Sampling was conducted by a simple random sampling technique. The sample size in this study was 60 samples. The data collected was secondary data from medical records at Nosarara and Patoloan Public Health Centers, Palu City. Multivariate analysis used to determine the main risk of the incidence of neonatal asphyxia.
RESULTS
The results showed the Prolong Parturition OR=5.714 (95% CI 1.724-18.944); Prematurity OR=4.333 (95% CI 1.203-15.605); LBW OR=7.000 (95% CI 1.381-35.487).
CONCLUSION
risk factors for neonatal asphyxia were prolonged labour, prematurity, and LBW. The main factors causing neonatal asphyxia were LBW.
Topics: Asphyxia Neonatorum; Case-Control Studies; Female; Humans; Incidence; Infant, Newborn; Pregnancy; Public Health; Risk Factors
PubMed: 34929795
DOI: 10.1016/j.gaceta.2021.07.009 -
Neonatology 2021Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging... (Review)
Review
Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants.
Topics: Asphyxia Neonatorum; Delivery Rooms; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Pregnancy; Resuscitation
PubMed: 34023837
DOI: 10.1159/000516429 -
Molecules (Basel, Switzerland) Jan 2023Perinatal asphyxia is considered to be one of the major causes of brain neurodegeneration in full-term newborns. The worst consequence of perinatal asphyxia is... (Review)
Review
Perinatal asphyxia is considered to be one of the major causes of brain neurodegeneration in full-term newborns. The worst consequence of perinatal asphyxia is neurodegenerative brain damage, also known as hypoxic-ischemic encephalopathy. Hypoxic-ischemic encephalopathy is the leading cause of mortality in term newborns. To date, due to the complex mechanisms of brain damage, no effective or causal treatment has been developed that would ensure complete neuroprotection. Although hypothermia is the standard of care for hypoxic-ischemic encephalopathy, it does not affect all changes associated with encephalopathy. Therefore, there is a need to develop effective treatment strategies, namely research into new agents and therapies. In recent years, it has been pointed out that natural compounds with neuroprotective properties, such as melatonin, can be used in the treatment of hypoxic-ischemic encephalopathy. This natural substance with anti-inflammatory, antioxidant, anti-apoptotic and neurofunctional properties has been shown to have pleiotropic prophylactic or therapeutic effects, mainly against experimental brain neurodegeneration in hypoxic-ischemic neonates. Melatonin is a natural neuroprotective hormone, which makes it promising for the treatment of neurodegeneration after asphyxia. It is supposed that melatonin alone or in combination with hypothermia may improve neurological outcomes in infants with hypoxic-ischemic encephalopathy. Melatonin has been shown to be effective in the last 20 years of research, mainly in animals with perinatal asphyxia but, so far, no clinical trials have been performed on a sufficient number of newborns. In this review, we summarize the advantages and limitations of melatonin research in the treatment of experimental and clinical perinatal asphyxia.
Topics: Humans; Animals; Pregnancy; Female; Infant, Newborn; Hypoxia-Ischemia, Brain; Asphyxia; Melatonin; Hypothermia; Asphyxia Neonatorum; Brain Injuries
PubMed: 36770769
DOI: 10.3390/molecules28031105 -
Global Health, Science and Practice Oct 2018The revised Helping Babies Breathe training package now emphasizes the need for regular practice and quality improvement—an important improvement since more is needed...
The revised Helping Babies Breathe training package now emphasizes the need for regular practice and quality improvement—an important improvement since more is needed than one-off training to have substantial impact on asphyxia-related newborn mortality.
Topics: Asphyxia Neonatorum; Cardiopulmonary Resuscitation; Clinical Competence; Humans; Infant
PubMed: 30287525
DOI: 10.9745/GHSP-D-18-00291 -
Canadian Medical Association Journal Aug 1947
Topics: Asphyxia; Asphyxia Neonatorum; Humans; Infant, Newborn; Resuscitation
PubMed: 20253848
DOI: No ID Found -
Fetal Diagnosis and Therapy 2022Fetal, perinatal, and neonatal asphyxia are vital health issues for the most vulnerable groups in human beings, including fetuses, newborns, and infants. Severe... (Review)
Review
Fetal, perinatal, and neonatal asphyxia are vital health issues for the most vulnerable groups in human beings, including fetuses, newborns, and infants. Severe reduction in oxygen and blood supply to the fetal brain can cause hypoxic-ischemic encephalopathy (HIE), leading to long-term neurological disorders, including mental impairment and cerebral palsy. Such neurological disorders are major healthcare concerns. Therefore, there has been a continuous effort to develop clinically useful diagnostic tools for accurately and quantitatively measuring and monitoring blood and oxygen supply to the fetal and neonatal brain to avoid severe consequences of asphyxia HIE and neonatal encephalopathy. Major diagnostic technologies used for this purpose include fetal heart rate monitoring, fetus scalp blood sampling, ultrasound imaging, magnetic resonance imaging, X-ray computed tomography, and nuclear medicine. In addition, given the limitations and shortcomings of traditional diagnostic methods, emerging technologies such as near-infrared spectroscopy and photoacoustic imaging have also been introduced as stand-alone or complementary solutions to address this critical gap in fetal and neonatal care. This review provides a thorough overview of the traditional and emerging technologies for monitoring fetal and neonatal brain oxygenation status and describes their clinical utility, performance, advantages, and disadvantages.
Topics: Asphyxia Neonatorum; Brain; Female; Fetus; Humans; Hypoxia; Hypoxia-Ischemia, Brain; Infant; Infant, Newborn; Pregnancy
PubMed: 34872080
DOI: 10.1159/000520987 -
Tidsskrift For Den Norske Laegeforening... Nov 2012Perinatal asphyxia can cause serious illness or death. By taking steps in the «latent phase», which occurs 6-24 hours after the hypoxic event, the neurological damage... (Review)
Review
BACKGROUND
Perinatal asphyxia can cause serious illness or death. By taking steps in the «latent phase», which occurs 6-24 hours after the hypoxic event, the neurological damage caused by perinatal asphyxia can be limited. We wish to present a selection of such measures that are either established treatment today or that appear promising.
METHOD
We searched in the Medline and Cochrane Library databases for options for treating perinatal asphyxia.
RESULTS
An overwhelming number of potential treatments were identified. From among them we selected 44 indexed, peer-reviewed original articles in English on strategies for neuroprotective treatment after perinatal asphyxia. The treatments target different cellular mechanisms that cause neurological damage following perinatal asphyxia. In randomised clinical trials, only hypothermia treatment has improved the long-term outcome for newborns with perinatal asphyxia. Xenon gas, erythropoeitin and allopurinol are undergoing clinical testing.
INTERPRETATION
The efficacy of xenon gas, erythropoeitin and allopurinol in combination with the established treatment form of hypothermia must be studied more closely. Antioxidants, stem cell treatment and DNA repair mechanisms can pave the way for new opportunities in the future.
Topics: Allopurinol; Anesthetics, Inhalation; Asphyxia Neonatorum; Combined Modality Therapy; Erythropoietin; Free Radical Scavengers; Humans; Hypothermia, Induced; Infant, Newborn; Neuroprotective Agents; Time Factors; Xenon
PubMed: 23160590
DOI: 10.4045/tidsskr.12.0120