Hemodynamic optimization for neonates with neonatal encephalopathy caused by a hypoxic ischemic event: Physiological and therapeutic considerations

Danielle R Rios; Anie Lapointe; Georg M Schmolzer; Khorshid Mohammad; Krisa P VanMeurs; Roberta L Keller; Arvind Sehgal; Satyan Lakshminrusimha; Regan E Giesinger; Newborn Brain Society Guidelines and Publications Committee

doi:10.1016/j.siny.2021.101277

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Hemodynamic optimization for neonates with neonatal encephalopathy caused by a hypoxic ischemic event: Physiological and therapeutic considerations

Journal article

Peer reviewed

Hemodynamic optimization for neonates with neonatal encephalopathy caused by a hypoxic ischemic event: Physiological and therapeutic considerations

Danielle R Rios, Anie Lapointe, Georg M Schmolzer, Khorshid Mohammad, Krisa P VanMeurs, Roberta L Keller, Arvind Sehgal, Satyan Lakshminrusimha, Regan E Giesinger and Newborn Brain Society Guidelines and Publications Committee

Seminars in fetal & neonatal medicine, Vol.26(4), pp.101277-101277

08/2021

DOI: 10.1016/j.siny.2021.101277

PMID: 34481738

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Abstract

Neonatal encephalopathy due to a hypoxic-ischemic event is commonly associated with cardiac dysfunction and acute pulmonary hypertension; both therapeutic hypothermia and rewarming modify loading conditions and blood flow. The pathophysiological contributors to disease are complex with a high degree of clinical overlap and traditional bedside measures used to assess circulatory adequacy have multiple confounders. Comprehensive, quantitative echocardiography may be used to delineate the relative contribution of lung parenchymal, pulmonary vascular, and cardiac disease to hypotension and/or hypoxemic respiratory failure. In this review, we provide a detailed overview of the contributors to hemodynamic instability following perinatal hypoxic-ischemic injury. Our proposed approach to therapy focuses on physiopathological considerations with interventions individualized to this potentially complex condition and considers the pharmacological idiosyncrasies, which may occur among neonates with NE presenting with multiorgan dysfunction while undergoing therapeutic hypothermia.

Echocardiography

Hemodynamics

Humans

Hypothermia, Induced

Hypoxia-Ischemia, Brain - complications

Hypoxia-Ischemia, Brain - therapy

Infant, Newborn

Rewarming

Details

Title: Subtitle: Hemodynamic optimization for neonates with neonatal encephalopathy caused by a hypoxic ischemic event: Physiological and therapeutic considerations
Creators: Danielle R Rios - University of Iowa
Anie Lapointe - Centre Hospitalier Universitaire Sainte-Justine
Georg M Schmolzer - University of Alberta
Khorshid Mohammad - University of Calgary
Krisa P VanMeurs - Stanford University
Roberta L Keller - University of California, San Francisco
Arvind Sehgal - Monash University
Satyan Lakshminrusimha - University of California, Davis
Regan E Giesinger - University of Iowa
Newborn Brain Society Guidelines and Publications Committee
Resource Type: Journal article
Publication Details: Seminars in fetal & neonatal medicine, Vol.26(4), pp.101277-101277
DOI: 10.1016/j.siny.2021.101277
PMID: 34481738
ISSN: 1744-165X
eISSN: 1878-0946
Language: English
Date published: 08/2021
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984354149402771

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