【体外膜肺ECMO精品课件】 What is Hot and What is Cold in Newborn Hypoxic–Ischemic Brain Injury.pptVIP

What is Hot and What is Cold in Newborn Hypoxic–Ischemic Brain Injury;Cold is Hot;Three Trials’ Results;Hypothermia;Chance of Normal Outcome;Smaller Trials;Severity of Encephalopathy;Unfavorable Outcomes;Old is Cold;ST analysis;Apgar Score at 10 min;Can Serial Examination Prognosticate;Biomarkers of HIE;MRI Biomarkers of HIE;MRI Biomarkers of HIE;MRI Biomarkers of HIE;Cohort study - 35 hypothermic neonates with 25 controls. Whole body cooling, 36 weeks, moderate-severe encephalopathy MRI 1.5T, median 5 days hypothermia group, 4 days control group, ~ 1 hr. Hypothermia has less total, basal ganglia and thalamic scores for injury, and watershed lesions on MRI. All babies with decreased fetal movement antenatally had MRI injury in both groups. Limitations: Controls had higher encephalopathy score day 1 and MRI at earlier time; MRI could have been done earlier.;131 infants of 352 infants in the TOBY trial got MRI. Subset of infants had more severe aEEG findings. MRI was obtained at a median of 8 days (2-30). 63% of MRI scans 8days had major abnormalities predictive of abnormal outcome. 47% of MRI scans 8 days were predictive. Predictive accuracy of moderate/severe lesions in basal ganglia and thalamus, severe WM lesions, or an abnormal PLIC, for death or severe disability was 84% in cooled and 81% in non-cooled group. ;MRI Biomarkers of HIE;Summary;TIMING;PROOFS