Skip to main content

Asphyxia and hypoxic-ischemic encephalopathy in neonates: postnatal interventions

  • Chapter
Anaesthesia and Intensive Care in Neonates and Children

Part of the book series: Topics in Anaesthesia and Critical Care ((TIACC))

  • 109 Accesses

Abstract

The birth of an asphyxiated neonate is a dramatic event that can affect both the probability of survival and the quality of life of the neonate. About 6/1 000 newborn infants develop asphyxia [1], with a mortality rate of 15%–20% (due to a multiorgan failure syndrome and respiratory complications) and a further 25% probability of later neurodevelopmental sequelae due to hypoxic-ischemic encephalopathy (HIE) [2]. Even when electronically monitoring fetal heart rate, asphyxia is not detected before birth in about 50% of severe cases [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Levene MI, Kornberg J, Williams THC (1985) The incidence of and severity of postasphyxial encephalopathy in full-term infants. Early Hum Devel 11:21–28

    Article  CAS  Google Scholar 

  2. Levene MI (1995) Management and outcome of birth asphyxia. In: Levene MI, Bennett MJ, Punt J (eds) Fetal and neonatal neurology and neurosurgery. Churchill Livingstone, Edinburgh, pp 427–442

    Google Scholar 

  3. Spencer JAD (1998) Deaths related to intrapartum asphyxia. Br Med J 316:640

    Article  CAS  Google Scholar 

  4. Levene MI, Gibson NA, Fenton AC et al (1990) The use of a calcium-channel blocker, nicardipine, for severely asphyxiated newborn infants. Dev Med Child Neurol 32:567–574

    Article  PubMed  CAS  Google Scholar 

  5. Russell GA, Cooke RW (1995) Randomised controlled trial of allopurinol prophylaxis in very preterm infants. Arch Dis Child 73:F27–F31

    CAS  Google Scholar 

  6. Bennet P, Edwards AD (1997) Use of magnesium sulphate in obstetrics. Lancet 350:1491

    Article  Google Scholar 

  7. Levene MI (1993) Management of the asphyxiated full-term infant. Arch Dis Child 68:612–616

    Article  PubMed  CAS  Google Scholar 

  8. Shankaran S (1993) Perinatal asphyxia. Clin Perinatol 20(2)

    Google Scholar 

  9. Edwards AD (1993) Protection against hypoxic-ischaemic cerebral injury in the developing brain. Perfusion 8:97–100

    Article  Google Scholar 

  10. Bowen FW (1996) Management issues for the neonatal patient. Clin Perinatol 23:1–30

    PubMed  CAS  Google Scholar 

  11. Saugstad OD (1996) Role of xantine oxidase and its inhibitor in hypoxia: reoxygenation injury. Pediatrics 98:103–107

    PubMed  CAS  Google Scholar 

  12. Saugstad OD (1996) Mechanisms of tissue injury by oxygen radicals: implication for neonatal disease. Acta Paediatr 85:1–4

    Article  PubMed  CAS  Google Scholar 

  13. Vannucci RC, Perlman JM (1997) Intervention for perinatal hypoxic-ischemic encephalopathy. Pediatrics 100:1004–1014

    Article  PubMed  CAS  Google Scholar 

  14. Patel J, Edwards AD (1997) Prediction of neurological outcome after perinatal asphyxia. Curr Opin Pediatr 9:128–132

    Article  PubMed  CAS  Google Scholar 

  15. Azzopardi D, Wyatt JS, Cady EB et al (1989) Prognosis of newborn infants with hypoxic-ischemic brain injury assessed by phosphorus magnetic resonance spectroscopy. Pediatr Res 25:445–451

    Article  PubMed  CAS  Google Scholar 

  16. Sarnat HB, Sarnat MS (1976) Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 33:696–705

    Article  PubMed  CAS  Google Scholar 

  17. Prechtl HFR, Ferrari F, Cioni G (1993) Predictive value of general movements in asphyxiated fullterm infants. Early Hum Devel 35:91–120

    Article  CAS  Google Scholar 

  18. Cioni G, Ferrari F, Einspieler C et al (1997) Neurological assessment of preterm infants: comparison between observation of spontaneous movements and neurological examination. J Pediatr 130:704–711

    Article  PubMed  CAS  Google Scholar 

  19. Lucey JF (1997) Neuroprotection and perinatal brain care: the field of the future, currently going nowhere. Pediatrics 100:1030–1031

    Article  PubMed  CAS  Google Scholar 

  20. Hall RT, Hall FK, Daily DK (1998) High-dose phenobarbital therapy in term newborn infants with severe perinatal asphyxia: a randomized, prospective study with three-year follow-up. J Pediatr 132:345–348

    Article  PubMed  CAS  Google Scholar 

  21. Catlin EA, Carpenter MW, Brann BS et al (1986) The Apgar score revisited: influence of gestational age. J Pediatr 109:865–868

    Article  PubMed  CAS  Google Scholar 

  22. American Heart Association, Emergency Cardiac Care Committee and Subcommittees (1992) Guidelines for cardiopulmonary resuscitation and emergency cardiac care. VII. Neonatal resuscitation. JAMA 268:2276–2281

    Article  Google Scholar 

  23. Bloom RS, Cropley C (1987) Textbook of neonatal resuscitation. AHA and AAP, Dallas

    Google Scholar 

  24. Saugstad OD (1996) Resuscitation of newborn infants; do we need new guidelines? Prenatal Neonatal Med 1:26–28

    Google Scholar 

  25. Lundstrom KE, Pryds O, Greisen G (1995) Oxygen at birth and prolonged cerebral vasoconstriction in preterm infants. Arch Dis Child 73:F81–F86

    CAS  Google Scholar 

  26. Feet BA, Yu X-Q, Rootwelt T et al (1997) Effects of hypoxemia and reoxygenation with 21% or 100% oxygen in newborn piglets: extracellular hypoxanthine in cerebral cortex and femoral muscle. Crit Care Med 25:1384–1391

    Article  PubMed  CAS  Google Scholar 

  27. Ramji S, Ahuja S, Thirupuram S et al (1993) Resuscitation of asphyxic newborn infants with room air or 100% oxygen. Pediatr Res 34:809–812

    Article  PubMed  CAS  Google Scholar 

  28. Saugstad OD, Rootwelt T, Aalen O (1998) Resuscitation of asphyxiated newborn infants with room air or oxygen: an international controlled trial. The RESAIR 2 study. Pediatrics 102:E1

    Article  PubMed  CAS  Google Scholar 

  29. Leahy FAN, Cates D, MacCallum M, Rigatto H (1980) Effects of CO2 and 100% O2 on cerebral blood flow in preterm infants. J Appl Physiol 48:468–472

    PubMed  CAS  Google Scholar 

  30. Rahilly PM (1980) Effects of 2% CO2, 0.5% CO2 and 100% oxygen on cranial blood flow of the human neonate. Pediatrics 66:685–689

    PubMed  CAS  Google Scholar 

  31. Mehmet H, Edwards AD (1996) Hypoxia, ischaemia, and apoptosis. Arch Dis Child 75:F73–F75

    CAS  Google Scholar 

  32. Roth SC, Edwards AD, Cady EB et al (1992) Relation between cerebral oxidative metabolism following birth asphyxia and neurodevelopmental outcome and brain growth at one year. Dey Med Child Neurol 34:285–295

    Article  CAS  Google Scholar 

  33. Lorek A, Takei Y, Cady EB et al (1994) Delayed (“secondary”) cerebral energy failure following acute hypoxia-ischaemia in the newborn piglet: continuous 48-hour studies by 31P magnetic resonance spectroscopy. Pediatr Res 36:699–706

    Article  PubMed  CAS  Google Scholar 

  34. Edwards AD, Wyatt JS, Thoresen M (1998) Treatment of hypoxic-ischaemic brain damage by moderate hypothermia. Arch Dis Child 78:F85–F91

    Article  CAS  Google Scholar 

  35. Du C, Hu R, Csernansky CA et al (1996) Very delayed infarction after mild focal cerebral ischemia: a role for apoptosis? J Cereb Blood Flow Metab 16:195–201

    Article  PubMed  CAS  Google Scholar 

  36. Gluckman PD, Klempt N, Guan J et al (1992) A role for IGF-1 in the rescue of CNS neurons following hypoxic-ischemic injury. Biochem Biophys Res Commun 182:593–599

    Article  PubMed  CAS  Google Scholar 

  37. Thoresen M, Wyatt JS (1997) Keeping a cool head, post-hypoxic hypothermia-an old idea revisited. Acta Paediatr 86:1029–1033

    Article  PubMed  CAS  Google Scholar 

  38. Wyatt JS, Thoresen M (1997) Hypothermia treatment and the newborn. Pediatrics 100:1028–1030

    Article  PubMed  CAS  Google Scholar 

  39. Westin B, Miller JA, Nyberg R et al (1959) Neonatal asphyxia pallida treated with hypothermia alone or with hypothermia and exchange transfusion of oxygenated blood. Surgery 45:868–879

    PubMed  CAS  Google Scholar 

  40. Oates RK, Harvey D (1976) Failure of hypothermia as treatment of asphyxiated newborn rabbits. Arch Dis Child 51:512–516

    Article  PubMed  CAS  Google Scholar 

  41. Sirimanne E, Blumberg RM, Bossano B et al (1996) The effect of prolonged modification of cerebral temperature on outcome following hypoxic-ischemic brain injury in the infant rat. Pediatr Res 39:591–597

    Article  PubMed  CAS  Google Scholar 

  42. Silverman WA, Fertig JW, Berger AP (1958) The influence of the thermal environment upon the survival of newly born premature infants. Pediatrics 22:876–886

    PubMed  CAS  Google Scholar 

  43. Grether JK, Nelson KB (1997) Maternal infection and cerebral palsy in infants of normal birth weight. JAMA 278:207–211

    Article  PubMed  CAS  Google Scholar 

  44. Silverman WA (1998) Cooling the asphyxiated newborn-responsibly. Pediatrics 101:697–698

    Article  PubMed  CAS  Google Scholar 

  45. Edwards AD, Azzopardi D (1998) Hypothermic neural rescue treatment: from laboratory to cotside? Arch Dis Child 78:F88–F91

    CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Italia

About this chapter

Cite this chapter

Motta, G., Gagliardi, L., Introvini, P. (1999). Asphyxia and hypoxic-ischemic encephalopathy in neonates: postnatal interventions. In: Salvo, I., Vidyasagar, D. (eds) Anaesthesia and Intensive Care in Neonates and Children. Topics in Anaesthesia and Critical Care. Springer, Milano. https://doi.org/10.1007/978-88-470-2282-9_15

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2282-9_15

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0043-8

  • Online ISBN: 978-88-470-2282-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics