Document Detail


Perinatal events and early magnetic resonance imaging in therapeutic hypothermia.
MedLine Citation:
PMID:  20965514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the association between perinatal events and the pattern and extent of brain injury on early magnetic resonance imaging in newborn infants with and without therapeutic hypothermia for hypoxic-ischemic encephalopathy.
STUDY DESIGN: We performed a cohort study of 35 treated and 25 nontreated neonates who underwent magnetic resonance imaging. The injury patterns were defined a priori as: normal, watershed, or basal ganglia/thalamus-predominant, as well as a dichotomous outcome of moderate-to-severe versus mild-no injury.
RESULTS: Neonates with hypothermia had less extensive watershed and basal ganglia/thalamus injuries and a greater proportion had normal imaging. Therapeutic hypothermia was associated with a decreased risk of both basal ganglia/thalamus injury (relative risk, 0.29; 95% CI, 0.10 to 0.81, P = .01) and moderate-severe injury. Neonates with sentinel events showed a decrease in basal ganglia/thalamus-predominant injury and an increase in normal imaging. All neonates with decreased fetal movements had injury, predominantly watershed, regardless of therapeutic hypothermia.
CONCLUSIONS: These results validate reports of reduced brain injury after therapeutic hypothermia and suggest that perinatal factors are important indicators of response to treatment.
Authors:
Sonia L Bonifacio; Hannah C Glass; Juliana Vanderpluym; Ashish T Agrawal; Duan Xu; A James Barkovich; Donna M Ferriero
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2010-10-20
Journal Detail:
Title:  The Journal of pediatrics     Volume:  158     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  2011-04-05     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  360-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
Affiliation:
Division of Neonatology, University of California San Francisco, School of Medicine, 533 Parnassus Avenue, U585, Box 0748, San Francisco, CA 94143-0748, USA. bonifacios@peds.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Hypothermia, Induced*
Hypoxia-Ischemia, Brain / pathology*,  therapy*
Infant, Newborn
Logistic Models
Magnetic Resonance Imaging*
Male
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 NS066137-02/NS/NINDS NIH HHS; L40 NS060616-03/NS/NINDS NIH HHS; P50 NS035902-050001/NS/NINDS NIH HHS; P50 NS035902-12/NS/NINDS NIH HHS; UL1 RR024131-01/RR/NCRR NIH HHS

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