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[Hypothermia after perinatal asphyxia reduces the risk of brain damage. But it's too early to recommend the method for routine treatment].

Two randomised controlled trials evaluating intervention with moderate hypothermia after perinatal asphyxia will probably be published this year. The first study, evaluating head cooling with a "cool cap" is already published, and preliminary data from the other study evaluating body cooling earlier have been presented. Both studies indicate that moderate hypothermia, initiated within 6 h after birth, for 72 h reduces mortality and survival with severe brain injury. Several issues must, however, be solved before postasphyctic cooling can be recommended as clinical routine. There are no data on optimal duration, degree of cooling, best method, or if methods and degree of cooling should be adapted to type of brain injury. Continued research with randomised controlled trials is recommended.

Asphyxia Neonatorum↗
PubMed1990

[Ultrastructural features of heart insufficiency and its correction during the post-asphyxia period].

The ultrastructure of myocardium was studied in the experiments on rats during 24 hours after 6-min mechanical asphyxia with following clinical death. It has been established that the contractile cardiac apparatus of myocytes lesions on the intracellular edema background is the main while energy production process impairs insignificantly. The effectiveness of anti-hypoxia, membrane stability and protease inhibiting preparations for prevention of postresuscitation myocardium lesion was examined. The contrykal protective action, suppressing the proteolytic ferment hyperactivity was determined.

Animals↗
PubMed1991

[An immunochemical analysis of the function of the hemato-encephalic barrier in acute fetal hypoxia and asphyxia neonatorum].

The neurospecific protein alpha 1-globulin has been assayed in serum in order to evaluate the blood-brain barrier in newborns with acute intrapartum hypoxia. The study involved 35 term newborns with birth asphyxia of variable severity. The alpha 1-globulin levels correlated with severity of condition at birth, duration of intrauterine exposure to hypoxia and the presence of obstetric complications and clinical severity of cerebral circulatory disorders. A normal early adaptation and effective therapy reduced serum alpha 1-globulin levels 4-8-fold on the 3rd postnatal day and 6-16-fold on the 5th day. Deterioration of neurological symptoms was parallelled by a significant increase in protein levels (to 6400 ng/ml) at day 5. This evidence may confirm the fact that permeability of the blood-brain barrier is impaired by intrapartum hypoxia.

Acute Disease↗
PubMed1991

[Use of integrated echocardiography in the evaluation of neonatal asphyxia].

Perinatal asphyxia provides a dramatic example of vulnerability of the cardiovascular system during adaptation to the extrauterine life. The clinical picture is variable, depending upon the severity of perinatal stress and the individual response of pulmonary vascular bed and myocardium. Doppler Echocardiography is a reliable and noninvasive method which allows both the ruling out of congenital heart disease and the making of an early diagnosis in these neonates.

Asphyxia Neonatorum↗
PubMed1991

[Effects of cardiac denervation on its function in asphyxia].

It has been established in 23 experiments on dogs that during asphyxia the reactions of denervated heart which were directed toward compensation of hypoxia in the whole organism and towards preservation of myocardium from hypoxia damages were slower than that in the norm. All these processes led to the overloading of myocardium.

Animals↗
PubMed1991

Renal failure in symptomatic perinatal asphyxia.

The study included seven term newborns developing acute renal failure due to symptomatic perinatal asphyxia in early neonatal period. Its diagnosis was based on clinical and biochemical indices. Urinary output, serum and urinary sodium, potassium and creatinine, and blood urea nitrogen were evaluated in all of them. All the patients had oliguria not responding to fluid challenge and/or diuretic therapy, high serum K, FeNa of greater than 2.5% and RFI of greater than 3 indicative of intrinsic renal disease. The condition was associated with a very high mortality.

Acute Kidney Injury↗
PubMed1991

[Fatty degeneration of liver sinusoids in fetal asphyxia].

The fat content of the liver sinusoidal cells was examined partly systematically partly by selected case groups from 297 cases. While minor grades of lipid content within these cells was found nearly equally spread at all causes of death the most intensive fat accumulation was seen at cases of violent asphyxia.

Asphyxia↗
PubMed1991

Perinatal asphyxia: surveillance of the high-risk fetus.

Methods of testing to identify the fetus at risk for developing perinatal asphyxia continue to be developed and refined. The perinatal nurse needs to be knowledgeable of each test's purpose, capabilities, limitations, and clinical issues. Appropriate nursing interventions based on this knowledge facilitates the testing process and promotes the goal of improved perinatal outcome.

Asphyxia Neonatorum↗
PubMed1991

Neonatal consequences of asphyxia.

The neonatal consequences of asphyxia involve multiple organ systems in the newborn. These include the brain, cardiovascular system, pulmonary system, kidneys, liver, and gastrointestinal systems. The multiorgan involvement makes the nursing care of these infants especially challenging. An understanding of the pathophysiology and nursing implications will aid the nurse responsible in caring for the asphyxiated infant.

Asphyxia Neonatorum↗
PubMed1991

[Diagnosis and emergency aid in traumatic asphyxia].

Traumatic asphyxia in compression of the chest in 51 casualties is analysed. This type of affection accounts for 0.2-1.1% of chest traumas, but under definite circumstances it may prevail and reach 75-80%, which was encountered by the authors during a mass catastrophe. The most characteristic manifestations of this type of chest trauma are pathological conditions of the organs of vision, skin symptomatology, damage to the central nervous system and the cardiovascular system; the thoracic organs and the costal frame suffer less. The treatment must be strictly differentiated: resuscitation measures with artificial lung ventilation and timely cleansing of the tracheobronchial tree are indicated in severe and extremely severe forms; dehydration, cardiac, and anti-inflammatory therapy are indicated in moderately severe forms, and symptomatic therapy is indicated in the mild form. Consultation with specialists in other fields of medicine (ophthalmologist, neurologist, neurosurgeon, psychiatrist) is advisable in all cases.

Adolescent↗
PubMed1990

Liver dysfunction in severe birth asphyxia.

A total of 46 full term, appropriate for gestational age neonates were included in this study. Out of this, 31 infants had suffered severe birth asphyxia, while 15 normal babies formed the control group. The liver function tests of the asphyxiated group was deranged in 64.52% babies. There was 60% mortality in asphyxiated babies with deranged liver function. The serum levels of transaminases (SGOT, SGPT) and alkaline phosphatase in non-survivors were significantly higher than those of survivors.

Asphyxia Neonatorum↗
PubMed1990

[Transient myocardial ischemia in newborn babies with perinatal asphyxia (hypoxic cardiomyopathy)].

A prospective study in 76 newborn with perinatal asphyxia searching for myocardial ischemia was carried out. The disease was found in 51% of the patients. With electrocardiogram, myocardial enzymes, X ray and clinical manifestations the diagnosis was elaborated. No difference in the sex was present, the mean of gestational age was 35 weeks, and with mean birth weight 2,216 g, respiratory distress was present in all the people; only 20.5% developed heart failure and two had heart murmurs; 61.5% showed cardiomegaly. The creatine kinase MB isoenzyme at twelve hours after birth was raised in most of the patients. Respiratory distress syndrome was the principal diagnosis in 38%; hypoxic ischemic encephalopathy and peri-intraventricular hemorrhage was present in 50 and 33% of the patients, respectively. Mortality rate was 33%. Also a comparative study in the infants with and without myocardial ischemia was carried out appearing significative difference in: 1. Cardiomegaly, 2. Hypoxic-ischemic encephalopathy and 3. Creatine kinase MB isoenzyme.

Asphyxia Neonatorum↗
PubMed1990

Studies on asphyxia; on the changes of the alveolar walls of rats in the hypoxic state. III. The hypoxic state by carbon monoxide gas.

Experimental studies on asphyxia due to the hypoxic state produced by carbon monoxide gas were achieved. The morphological changes such as 1) faint pinkish homogeneous substance in the alveoli by H&E staining, 2) debris-like structure of medium electron dense substance on the surface of alveoli and/or full-filling the space of alveoli which were almost the same as observed in our previous reports except the appearance of a plenty of fibrin fibers in the debris-like structure and in part the close connection with myelin configurations as well.

Animals↗
PubMed1990

[A power spectral analysis of the EEG in the newborns. II. The power spectral changes of the infants with neonatal asphyxia].

Power spectral analysis of the EEG at the neonatal period was performed in 33 babies with an Apgar score of 6 or less 1 minute after delivery. Their gestational ages ranged from 27 to 40 weeks, and birth weight from 1,013 g to 4,416 g. They were followed up until 18 months of age. All EEGs were recorded when the babies reached to 37-41 weeks of conceptional age, and analyzed using fast Fourier transformation. The percent power in active sleep was evaluated in this study. The abnormal EEG patterns in infants with neurological damage was classified into the following groups: (1) Increase of the percent power of the delta 1 band, (2) Decrease of the percent of the power of the delta 1. On the other hand, the EEG patterns at the neonatal period in infants with normal development who suffered from neonatal asphyxia were similar to those of age-matched controls. These results suggest one of the most important factors deciding the prognosis of the brain damage is the presence of a normal percent pattern. In conclusion, power spectral analysis of EEG at the neonatal period is useful in predicting the outcome of brain damage if it is used with visual inspection.

Asphyxia Neonatorum↗
PubMed1989

Management of birth asphyxia by traditional birth attendants.

Birth asphyxia is an important cause of perinatal mortality, especially in developing countries. A study in India has shown that traditional birth attendants can recognize the condition but mostly cannot deal with it. The authors suggest that this deficiency could be overcome if suitable training were given.

Asphyxia Neonatorum↗
PubMed1985

Cerebral edema caused by perinatal asphyxia. Detection and follow-up.

Cerebral edema due to perinatal asphyxia in 2 full-term newborns was detected and monitored with a combination of real time ultrasound, computed tomography, and serial pulsatility-index determinations of the cerebral arteries using Doppler ultrasound. In both babies, real time ultrasound showed small or slitlike lateral ventricles, an increase in diffuse echogenicity and obliteration of normally visible structures in the acute phase suggesting cerebral edema. In the recovery phase a remarkable widening of the ventricles was seen. We also found a relationship between disturbances of consciousness (probably due to cerebral edema) and the pulsatility index. The combination of serial pulsatility-index determinations of the anterior cerebral arteries and real time ultrasound of the brain may in the future be a useful "bedside" method for early detection and follow-up of the cerebral edema.

Asphyxia Neonatorum↗
PubMed1988

Intrapartum asphyxia and cerebral palsy.

Signs of presumed hypoxia/asphyxia of the fetus are not uncommon and can be detected during labor, in the delivery room, and during the early neonatal period. Virtually no single sign or symptom has sufficient correlation to enable prediction of later cerebral palsy with a reasonable degree of medical certainty. To attribute cerebral palsy to prior asphyxia with reasonable certainty, there must be evidence that a substantial hypoxic injury occurred and that a sequence of events ensued which would prove the clinical impact of that hypoxic insult. Few cases of cerebral palsy meet these criteria.

Acidosis↗