Whole-body cooling after perinatal asphyxia: a pilot study in term neonates
Whole-body cooling after perinatal asphyxia: a pilot study in term neonates
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DOI：
10.1017/s0012162203000045
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发表时间：
2003-01-01
影响因子：
3.8
通讯作者：
Zupan, V
中科院分区：
文献类型：
--
作者：
Debillon, T;Daoud, P;Zupan, V
为了检验全身降温对中重度缺氧缺血性脑病（HIE）足月新生儿的实用性和安全性，并报告结果，对25例足月婴儿（经后年龄中位数38周，36 - 41周，男性20例，女性5例）进行了前瞻性试点研究。婴儿出生后6小时内开始全身降温，达到33至34摄氏度的目标核心温度，并持续72小时。25例新生儿（19例Sarnat II型，6例Sarnat III型，18例外生），18例存活，其中13例（72%）MRI脑信号正常。15例婴儿在降温过程中出现体温不稳定，但未见严重的血流动力学不稳定或肾功能衰竭。12例婴儿出现血小板减少症，其中7例为生物弥散性血管内凝血。1例低氧血症伴右至左动脉导管分流，7例脑膜或硬膜下出血。全身降温对足月新生儿是可行的，没有危及生命的不良事件。需要改进以获得稳定的低温。72小时。
In order to test the practicability and safety of whole-body cooling in term neonates with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE) and to report outcomes, a prospective pilot study was carried out in 25 term infants (median postmenstrual age 38 weeks, range 36 to 41 weeks; 20 males, five females). Whole-body cooling, to a target core temperature of 33 to 34degreesC, started within 6 hours of birth and was maintained for 72 hours. Of the 25 newborn infants (19 Sarnat II and six Sarnat III, 18 outborn), 18 survived, including 13 (72%) with normal cerebral signal by MRI. Temperature instability occurred during cooling in 15 infants, but neither severe haemodynamic instability nor renal failure was seen. Thrombocytopenia developed in 12 infants, including seven with biological disseminated intravascular coagulation. One patient had hypoxaemia with right-to-left shunting through the ductus arteriosus, and seven had limited meningeal or subdural bleeding. Whole-body cooling is feasible in term neonates, with no life-threatening adverse events. Improvements are needed to obtain stable hypothermia. for 72 hours.