Hipotermia terapéutica como neuroprotección en neonatos con encefalopatía hipóxica-isquémica
DOI:
https://doi.org/10.56048/MQR20225.7.2.2023.1373-1390Palabras clave:
Hipoxia isquémica encefálica, hipotermia inducida, Recién NacidoResumen
La encefalopatía hipóxico isquémico ha sido considerado como una de las causas de índices de mortalidad y discapacidad en los neonatos, producido por la falta de oxigenación al cerebro durante el nacimiento. Se han planteado diversos estudios para incurrir en tratamientos que permitan disminuir estos índices, uno de ellos ha demostrado mejoría para los neonatos con encefalopatía grave, como es la hipotermia terapéutica, considerada como neuro protectora y ha demostrado una disminución en la mortalidad y discapacidad del neonato. Se recomienda este plan terapéutico en neonatos con encefalopatía hipóxica grave durante las 6 primeras horas, reduciendo la temperatura corporal de 3 a 4 grados centígrados, con un apoyo multidisciplinario y un control estricto como cuidado de signos vitales, ventilación mecánica, control de temperatura y tratamiento farmacológico y nutricional. Se recomienda el uso de biomarcadores para el diagnóstico precoz de Encefalopatía Hipóxica Isquémica en conjunto con estudios de imagen. La terapia ha demostrado efectividad en neonatos con EHI de moderada-grave, aunque puede estar contraindicada en países en vías de desarrollo debido a la falta de preparación, por lo que se discuten tratamientos que incluyan neuroprotectoras para ser ocupada como una terapia combinada.
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Adams, M., Brotschi, B., Birkenmaier, A., Schwendener, K., Rathke, V., Kleber, M., Hagmann, C., Bassler, D., Natalucci, G., Böttger, S., Frey, B., Bernet, V., Grass, B., Rogdo, B., Hoigné, I., Stocker, M., Berger, T. M., Fontana, M., Hegi, L., … Schneider, J. (2021). Process variations between Swiss units treating neonates with hypoxic-ischemic encephalopathy and their effect on short-term outcome. Journal of Perinatology, 41(12), 2804. https://doi.org/10.1038/S41372-021-01156-W
Bersani, I., Piersigilli, F., Gazzolo, D., Campi, F., Savarese, I., Dotta, A., Tamborrino, P. P., Auriti, C., & Di Mambro, C. (2021). Heart rate variability as possible marker of brain damage in neonates with hypoxic ischemic encephalopathy: a systematic review. European Journal of Pediatrics, 180(5), 1335. https://doi.org/10.1007/S00431-020-03882-3
Birca, A., Lortie, A., Birca, V., Decarie, J. C., Veilleux, A., Gallagher, A., Dehaes, M., Lodygensky, G. A., & Carmant, L. (2016). Rewarming affects EEG background in term newborns with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 127(4), 2087–2094. https://doi.org/10.1016/J.CLINPH.2015.12.013
Blanco, D., García-Alix, A., Valverde, E., Tenorio, V., Vento, M., & Cabañas, F. (2011). Neuroprotección con hipotermia en el recién nacido con encefalopatía hipóxico-isquémica. Guía de estándares para su aplicación clínica. An Pediatr (Barc), 75(5), 1–341. https://doi.org/10.1016/j.anpedi.2011.07.012
Chiang, M. C., Jong, Y. J., & Lin, C. H. (2017). Therapeutic hypothermia for neonates with hypoxic ischemic encephalopathy. Pediatrics and Neonatology, 58(6), 475–483. https://doi.org/10.1016/J.PEDNEO.2016.11.001
Chin, E. M., Jayakumar, S., Ramos, E., Gerner, G., Soares, B. P., Cristofalo, E., Leppert, M., Allen, M., Parkinson, C., Johnston, M., Northington, F., & Burton, V. J. (2019a). Preschool language outcomes following perinatal hypoxic-ischemic encephalopathy in the age of therapeutic hypothermia. Developmental Neuroscience, 40(5–6), 1. https://doi.org/10.1159/000499562
Chin, E. M., Jayakumar, S., Ramos, E., Gerner, G., Soares, B. P., Cristofalo, E., Leppert, M., Allen, M., Parkinson, C., Johnston, M., Northington, F., & Burton, V. J. (2019b). Preschool language outcomes following perinatal hypoxic-ischemic encephalopathy in the age of therapeutic hypothermia. Developmental Neuroscience, 40(5–6), 1. https://doi.org/10.1159/000499562
Colantonio Viviana Robledo Juan Pablo Berazategui, G., & Valera Nora Balanian Teresa Mazzuchelli, M. (2017). Recomendación para el tratamiento con hipotermia en recién nacidos con encefalopatía hipóxico-isquémica. Arch Argent Pediatr, 115. https://doi.org/10.5546/aap.2017.s38
Fasce, J., Novoa, J. M., Toso, P., & García-Alix, A. (2021). Current status of Therapeutic Hypothermia in Hypoxic-Ischemic Encephalopathy. Revista Chilena de Pediatría; Vol. 92, Núm. 6 (2021): Noviembre - Diciembre; 831-837, 92(6), 831–837. https://doi.org/10.32641/ANDESPEDIATR.V92I6.4024
Fredricks, T. R., Gibson, C., Essien, F., & Benseler, J. S. (2017). Therapeutic Hypothermia to Treat a Newborn With Perinatal Hypoxic-Ischemic Encephalopathy. The Journal of the American Osteopathic Association, 117(6), 393–398. https://doi.org/10.7556/JAOA.2017.078
Garfinkle, J., Sant’Anna, G. M., Wintermark, P., Ali, N., Morneault, L., Koclas, L., & Shevell, M. I. (2013). Cooling in the real world: therapeutic hypothermia in hypoxic-ischemic encephalopathy. European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, 17(5), 492–497. https://doi.org/10.1016/J.EJPN.2013.03.006
Grzybowski, M., Singh, M., Shah, P. S., Lee, S., Toye, J., Kanungo, J., & Khurshid, F. (2022). Determining the Effect of Birth Weight on Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy. American Journal of Perinatology. https://doi.org/10.1055/S-0042-1742454
Hansen, G., Al Shafouri, N., Narvey, M., Vallance, J. K., & Srinivasan, G. (2016). High blood carbon dioxide variability and adverse outcomes in neonatal hypoxic ischemic encephalopathy. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 29(4), 680–683. https://doi.org/10.3109/14767058.2015.1015983
Lemyre, B., & Chau, V. (2018). Hypothermia for newborns with hypoxic-ischemic encephalopathy. Paediatrics & Child Health, 23(4), 285–291. https://doi.org/10.1093/PCH/PXY028
Marlow, N., Shankaran, S., Rogers, E. E., Maitre, N. L., & Smyser, C. D. (2021). Neurological and developmental outcomes following neonatal encephalopathy treated with therapeutic hypothermia. Seminars in Fetal and Neonatal Medicine, 26(5). https://doi.org/10.1016/j.siny.2021.101274
McNally, M. A., & Soul, J. S. (2019). Pharmacologic Prevention and Treatment of Neonatal Brain Injury. Clinics in Perinatology, 46(2), 311–325. https://doi.org/10.1016/J.CLP.2019.02.006
Mietzsch, U., Radhakrishnan, R., Boyle, F. A., Juul, S., & Wood, T. R. (2020). Active cooling temperature required to achieve therapeutic hypothermia correlates with short-term outcome in neonatal hypoxic-ischaemic encephalopathy. The Journal of Physiology, 598(2), 415–424. https://doi.org/10.1113/JP278790
Natarajan, G., Pappas, A., & Shankaran, S. (2016). Outcomes in childhood following therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy (HIE). Seminars in Perinatology, 40(8), 549–555. https://doi.org/10.1053/J.SEMPERI.2016.09.007
Okulu, E., Erdeve, O., Pekcici, B. B., Kendirli, T., Eyileten, Z., Atasay, B., & Arsan, S. (2019). A Successful Whole Body Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy During an ECMO Run in a Newborn. Frontiers in Pediatrics, 7(MAR), 95. https://doi.org/10.3389/FPED.2019.00095
O’Mara, K., & McPherson, C. (2021). Neuroprotective Agents for Neonates with Hypoxic-Ischemic Encephalopathy. Neonatal Network : NN, 40(6), 406–413. https://doi.org/10.1891/11-T-755
Ovali, F. (2022). Hemodynamic changes and evaluation during hypoxic-ischemic encephalopathy and therapeutic hypothermia. Early Human Development, 167, 105563. https://doi.org/10.1016/J.EARLHUMDEV.2022.105563
Ovcjak, A., Pontello, R., Miller, S. P., Sun, H. S., & Feng, Z. P. (2023). Hypothermia combined with neuroprotective adjuvants shortens the duration of hospitalization in infants with hypoxic ischemic encephalopathy: Meta-analysis. Frontiers in Pharmacology, 13, 5496. https://doi.org/10.3389/FPHAR.2022.1037131/BIBTEX
Pouppirt, N. R., Martin, V., Pagnotto-Hammitt, L., Spittle, A. J., Flibotte, J., & DeMauro, S. B. (2021). The General Movements Assessment in Neonates With Hypoxic Ischemic Encephalopathy. Journal of Child Neurology, 36(8), 601–609. https://doi.org/10.1177/0883073820981515
Romeo, D. M., Bompard, S., Serrao, F., Leo, G., Cicala, G., Velli, C., Gallini, F., Priolo, F., Vento, G., & Mercuri, E. (2019). Early Neurological Assessment in Infants with Hypoxic Ischemic Encephalopathy Treated with Therapeutic Hypothermia. Journal of Clinical Medicine, 8(8). https://doi.org/10.3390/JCM8081247
Stockley, E., & Gowda, H. (2022). A Case of an Infant with Hydrops Fetalis and Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia. Therapeutic Hypothermia and Temperature Management, 12(1), 43–46. https://doi.org/10.1089/THER.2021.0015
Turgut Meral Alagöz Hüseyi̇n Kaya İsmai̇l Kürşad Gökçe, H., Authors MEHMET FATİH DEVECİ, A., Turgut, H., Alagöz, M., Kaya, H., Kürşad Gökçe, I., Özdemi̇r, R., Med Sci, T. J., Fatih DEVECİ, M., & Turgut, H. (2022). Mortality Related Factors on Hypoxic Ischemic Encephalopathic Patients Treated with Therapeutic Hypothermia: A 11-year Single Center Experience. Turkish Journal of Medical Sciences, 52(3), 796–802. https://doi.org/10.55730/1300-0144.5375
Vayalthrikkovil, S., Bashir, R., Espinoza, M., Irvine, L., Scott, J. N., & Mohammad, K. (2020). Serum calcium derangements in neonates with moderate to severe hypoxic ischemic encephalopathy and the impact of therapeutic hypothermia: a cohort study. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 33(6), 935–940. https://doi.org/10.1080/14767058.2018.1510911
Wassink, G., Davidson, J. O., Dhillon, S. K., Zhou, K., Bennet, L., Thoresen, M., & Gunn, A. J. (2019). Therapeutic Hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy. Current Neurology and Neuroscience Reports, 19(2). https://doi.org/10.1007/S11910-019-0916-0
Wechselberger, K., Schmid, A., Posod, A., Höck, M., Neubauer, V., Fischer-Colbrie, R., Kiechl-Kohlendorfer, U., & Griesmaier, E. (2016). Secretoneurin Serum Levels in Healthy Term Neonates and Neonates with Hypoxic-Ischaemic Encephalopathy. Neonatology, 110(1), 14–20. https://doi.org/10.1159/000444245
Weng, B., Yan, C., Chen, Y., Gong, X., & Cai, C. (2021). Efficiency Evaluation of Neuroprotection for Therapeutic Hypothermia to Neonatal Hypoxic-Ischemic Encephalopathy. Frontiers in Neuroscience, 15, 875. https://doi.org/10.3389/FNINS.2021.668909/BIBTEX
Yum, S. K., Seo, Y. M., Kwun, Y., Moon, C. J., Youn, Y. A., & Sung, I. K. (2018). Therapeutic hypothermia in infants with hypoxic-ischemic encephalopathy and reversible persistent pulmonary hypertension: short-term hospital outcomes. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 31(23), 3108–3114. https://doi.org/10.1080/14767058.2017.1365123
Zhou, W. H., Cheng, G. Q., Shao, X. M., Liu, X. Z., Shan, R. B., Zhuang, D. Y., Zhou, C. Le, Du, L. Z., Cao, Y., Yang, Q., & Wang, L. S. (2010). Selective head cooling with mild systemic hypothermia after neonatal hypoxic-ischemic encephalopathy: a multicenter randomized controlled trial in China. The Journal of Pediatrics, 157(3). https://doi.org/10.1016/J.JPEDS.2010.03.030
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