Pang, R;
Mintoft, A;
Crowley, R;
Sellwood, M;
Mitra, S;
Robertson, NJ;
(2020)
Optimizing hemodynamic care in neonatal encephalopathy.
Seminars in Fetal and Neonatal Medicine
, 25
(5)
, Article 101139. 10.1016/j.siny.2020.101139.
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Abstract
Hemodynamic impairment occurs in up to 80% of infants with neonatal encephalopathy (NE). Not all infants benefit from therapeutic hypothermia (HT); there are some indications that the trajectory of brain injury might be modified by neurologic monitoring and early management over the first 72-h period. It is also possible that optimizing hemodynamic management may further improve outomes. The coupling between cerebral blood flow and cerebral metabolism is disrupted in NE, increasing the vulnerability of the newborn brain to secondary injury. Hemodynamic monitoring is usually limited to blood pressure and functional echocardiographic measurements, which may not accurately reflect brain perfusion. This review explores the evidence base for hemodynamic assessment and management of infants with NE while undergoing HT. We discuss the literature behind a systematic approach to a baby with NE with the aim to define best therapies to optimize brain perfusion and reduce secondary injury.
| Type: | Article |
|---|---|
| Title: | Optimizing hemodynamic care in neonatal encephalopathy |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.siny.2020.101139 |
| Publisher version: | https://doi.org/10.1016/j.siny.2020.101139 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| Keywords: | Neonatal encephalopathy, Cerebral autoregulation, Cerebral blood flow, Cardiovascular supportive therapies, Therapeutic hypothermia, Near infrared spectroscopy (NIRS) |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10108284 |
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