Hipoksik iskemik ensefalopatili yenidoğanlarda terapötik hipotermi

Hipoksik iskemik ensefalopati (HİE), yenidoğan ölümlerinin ve ciddi engelliliklerin en önemli nedenlerinden biridir. Hipoksik iskemik ensefalopati tablosunun enerji yetmezliklerine bağlı patogenezinin anlaşılmaya başlanması üzerine beyin hasarının azaltılması ve komplikasyonların engellenmesi için tedavi yöntemleri aranmıştır. Terapötik hipotermi, nöronal hücrelerin korunmasını hedefleyen tek tedavi yöntemidir. Hipoksinin şiddetine bağlı olarak tedavisi planlanan yenidoğanlar için literatürde birçok çalışma olsa da tedavi yöntemlerinin geliştirilmesi veya yenilerinin eklenmesi için araştırmalar sürmektedir.

Therapeutic hypothermia in newborns with hypoxic ischemic encephalopathy

Hypoxic ischemic encephalopathy (HIE) is one of the most important causes of neonatal deaths and serious disabilities. When the pathogenesis of HIE due to energy deficiencies began to be understood, treatment methods were sought to reduce brain damage and prevent complications. Therapeutic hypothermia is the only treatment method that aims to protect neuronal cells. Although there are studies in the literature for newborns who are planned to be treated depending on the severity of hypoxia, research continues to develop treatment methods or to add new ones.

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  • Gunn AJ, Laptook AR, Robertson NJ, Barks JD, Thoresen M, Wassink G et al. Therapeutic hypothermia translates from ancient history in to practice. Pediatr Res. 2017;81:202-9.
  • McDouall A, Wassink G, Bennet L, Gunn AJ, Davidson JO. Challenges in developing therapeutic strategies for mild neonatal encephalopathy. Neural Regen Res. 2022;17:277-82.
  • Bäcke P, Bruschettini M, Blomqvist YT, Olsson E. Interventions for the management of pain and sedation in newborns undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy (IPSNUT): protocol of a systematic review. Syst Rev. 2022;11:101.
  • Akcan AB, Kul M. Yenidoğanda tedavi amaçlı hipotermi uygulamaları. Van Tıp Dergisi. 2015;22:321-31.
  • Greco P, Nencini G, Piva I, Scioscia M, Volta CA, Spadaro S et al. Pathophysiology of hypoxic-ischemic encephalopathy: a review of the past and a view on the future. Acta Neurol Belg. 2020;120:277-88.
  • Allen KA, Brandon DH. Hypoxic ischemic encephalopathy: pathophysiology and experimental treatments. Newborn Infant Nurs Rev. 2011;11:125-33.
  • Chawla D. Biomarkers for prognostication in hypoxic-ischemic encephalopathy. Indian J Pediatr. 2020;87:777-8.
  • Wassink G, Davidson JO, Dhillon SK, Zhou K, Bennet L, Thoresen M et al. Therapeutic hypothermia in neonatal hypoxic-ischemic encephalopathy. Curr Neurol Neurosci Rep. 2019;19:2.
  • Russ JB, Simmons R, Glass HC. Neonatal encephalopathy: beyond hypoxic-ischemic encephalopathy. Neoreviews. 2021;22:e148-e162.
  • Gunn AJ, Thoresen M. Neonatal encephalopathy and hypoxic-ischemic encephalopathy. Handb Clin Neurol. 2019;162:217-37.
  • Cardinali DP. An assessment of melatonin's therapeutic value in the hypoxic-ischemic encephalopathy of the newborn. Front Synaptic Neurosci. 2019;11:34.
  • Silveira RC, Procianoy RS. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J Pediatr (Rio J). 2015;91:S78-83.
  • Çelik P. Hipoksik iskemik ensefalopati nedeniyle terapötik hipotermi uygulanan bebeklerin nörogelişimsel sonuçları. Türkiye Çocuk Hastalıkları Dergisi. 2021;15:359-64.
  • Balacan Z, Çalışır H. Terapotik hipotermi uygulanan hipoksik iskemik ensefalopatili yenidoğanların hemşirelik bakımı. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2017;6:225-34.
  • Chiang MC, Jong YJ, Lin CH. Therapeutic hypothermia for neonates with hypoxic ischemic encephalopathy. Pediatr Neonatol. 2017;58:475-83.
  • American Academy of Pediatrics, Committee on Fetus and Newborn. Hypothermia and neonatal encephalopathy. Pediatrics. 2014;133:1146-50.
  • Lampe JW, Becker LB. State of the art in therapeutic hypothermia. Annu Rev Med. 2011;62:79-93.
  • Akkoç H. Miyokardiyal iskemi reperfüzyon hasarı. Dicle Tıp Dergisi. 2008;35:211-5.
  • Sakr M. Neonatal therapeutic hypothermia. In StatPearls [Internet] (Ed P Balasundaram). Treasure Island (FL), StatPearls Publishing, 2022.
  • Nonato M, Gheler L, Balestrieri JV, Audi M, Prandini M. Selective head cooling and whole body cooling as neuroprotective agents in severe perinatal asphyxia. Rev Assoc Med Bras (1992). 2019;65:1116-21.
  • D’Alton ME, Hankins GDV, Berkowitz RL, Bienstock J, Ghidini A, Goldsmith J et al. Executive summary: neonatal encephalopathy and neurologic outcome, second edition. Report of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy. Obstet Gynecol. 2014;123:896–901.
  • American Academy of Pediatrics, Committee on Fetus and Newborn; American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. Guidelines for Perinatal Care (8th edition), Elk Grove Village (IL), American Academy of Pediatrics, 2017.
  • Walsh WF, Butler D, Schmidt JW. Report of a pilot study of cooling four preterm infants 32-35 weeks gestation with HIE. J Neonatal Perinatal Med. 2015;8:47-51.
  • Rao R, Trivedi S, Vesoulis Z, Liao SM, Smyser CD, Mathur AM. Safety and short-term outcomes of therapeutic hypothermia in preterm neonates 34-35 weeks gestational age with hypoxic-ischemic encephalopathy. J Pediatr. 2017;183:37-42.
  • Peliowski-Davidovich A; Canadian Paediatric Society, Fetus and Newborn Committee. Hypothermia for newborns with hypoxic ischemic encephalopathy. Paediatr Child Health. 2012;17:41-6.
  • Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976;33:696-705.
  • Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013.
  • Mosalli R. Whole body cooling for infants with hypoxic-ischemic encephalopathy. J Clin Neonatol. 2012;1:101-6.
  • Government of Western Australia Child and Adolescent Health Service, Neonatology. Guideline: hypoxic ischaemic encephalopathy (HIE) and therapeutic hypothermia. https://pch.health.wa.gov.au/~/media/HSPs/CAHS/Documents/Health-Professionals/Neonatology-guidelines/Hypoxic-Ischaemic-Encephalopathy-and-Therapeutic-Hypothermia.pdf?thn=0 (accessed 2022).
  • Mathew JL, Kaur N, Dsouza JM. Therapeutic hypothermia in neonatal hypoxic encephalopathy: a systematic review and meta-analysis. J Glob Health. 2022;12.
  • Clinical guidelines (nursing): therapeutic hypothermia in the neonate. https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Therapeutic_hypothermia_in_the_neonate/ (accessed 2022).
  • Guignard JP, Gilliéron P. Effect of modest hypothermia on the immature kidney. Acta Paediatr. 1997;86:1040-1.
  • Rohrer MJ, Natale AM. Effect of hypothermia on the coagulation cascade. Crit Care Med. 1992;20:1402-5.
  • Çevik G, Beken S, Aydın B, Dilli D, Zenciroğlu A, Okumuş N. Asfiktik bir yenidoğanda hipotermi tedavisi sonrasında gelişen subkutan yağ nekrozu olgusu. Gaziantep Medical Journal. 2013;19:188-90.
  • Atıcı A, Çelik Y, Gülaşı S, Turhan AH, Okuyaz Ç, Sungur MA. Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: short term results. Turk Pediatri Ars. 2015;50:27-36.