Cardiovascular Associations with Abnormal Brain Magnetic Resonance Imaging in Neonates with Hypoxic Ischemic Encephalopathy Undergoing Therapeutic Hypothermia and Rewarming

American Journal of Perinatology
Kiran S MorePatrick J McNamara

Abstract

This article compares hemodynamic characteristics of neonates with hypoxic ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) with normal versus abnormal brain magnetic resonance imaging (MRI). Serial echocardiography (echo) was performed within 24 hours, after 48 to 72 hours of cooling, within 24 hours of normothermia, and after starting feeds. Pulmonary hemodynamics, cardiac output, and ventricular function were evaluated. All neonates underwent brain MRI (day 4-5), per clinical standard of care. Clinical cardiovascular and echocardiography characteristics were compared between patients with normal versus abnormal MRI. Cardiovascular changes during TH and after rewarming were identified. Twenty neonates at median gestation and birth weight of 40 weeks (interquartile range [IQR]: 39, 41) and 3,410 g (IQR: 2,885, 4,093), respectively, were enrolled. Increased median left ventricular output (LVO) (106-159 mL/kg/min, p < 0.001) and reduced isovolumic relaxation time (IVRT) (48-42 ms, p < 0.001) were seen after rewarming. Echocardiography evidence of pulmonary hypertension (PH) was identified in five neonates. Eight neonates (40%) had brain injury identified on MRI (watershed [n = 4], basal ganglia [n = 4]); this...Continue Reading

Citations

Sep 1, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Sanjeev AggarwalGirija Natarajan
Jun 30, 2019·American Journal of Respiratory and Critical Care Medicine·Regan E GiesingerPatrick J McNamara
Jan 7, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Prashant AgarwalUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network
Feb 23, 2021·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·Vijverberg Joanna R GSylke J Steggerda
Apr 15, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Adrianne R BischoffRegan E Giesinger

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