The "neurovascular unit approach" to evaluate mechanisms of dysfunctional autoregulation in asphyxiated newborns in the era of hypothermia therapy.
The "neurovascular unit approach" to evaluate mechanisms of dysfunctional autoregulation in asphyxiated newborns in the era of hypothermia therapy.
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DOI：
10.1016/j.earlhumdev.2014.06.013
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发表时间：
2014-10
影响因子：
2.5
通讯作者：
Zhang, Rong
中科院分区：
文献类型：
--
作者：
Chalak, Lina F.;Tarumi, Takashi;Zhang, Rong
尽管产科和新生儿护理有所改善，并采用低温作为神经保护疗法，但围产期脑损伤仍然是脑瘫、智力迟钝和癫痫的常见原因。脑自动调节功能障碍的识别对于真实的时间有效性测量是必不可少的，以识别那些处于脑损伤最高风险的人。本文将重点介绍窒息新生儿的“神经血管单元”护理方法，以综述1）脑血流（CBF）调节功能障碍的潜在机制，2）最佳监测方法，如NIRS（近红外光谱）和TCD（经皮多普勒），3）在新生儿重症监护环境中进行低温和复温的窒息新生儿监测的临床意义。神经血管单位的功能调节的关键知识可能会导致改善的能力，预测结果在低温期间的真实的时间，以及区分无反应者谁可能受益于额外的治疗。
Despite improvements in obstetrical and neonatal care, and introduction of hypothermia as a neuroprotective therapy, perinatal brain injury remains a frequent cause of cerebral palsy, mental retardation and epilepsy. The recognition of dysfunction of cerebral autoregulation is essential for a real time measure of efficacy to identify those who are at highest risk for brain injury. This article will focus on the “neurovascular unit” approach to the care of asphyxiated neonates to review 1) potential mechanisms of dysfunctional cerebral blood flow (CBF) regulation, 2) optimal monitoring methodology such as NIRS (near infrared spectroscopy), and TCD (transcutaneous Doppler), and 3) clinical implications of monitoring in the neonatal intensive care setting in asphyxiated newborns undergoing hypothermia and rewarming. Critical knowledge of the functional regulation of the neurovascular unit may lead to improved ability to predict outcomes in real time during hypothermia, as well as differentiate nonresponders who might benefit from additional therapies.
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