Therapeutic hypothermia in asphyxiated newborns: selective head cooling vs. whole body cooling - comparison of short term outcomes.

OBJECTIVES: Therapeutic hypothermia TH became broadly used in the management of the asphyxiated newborns. Although two cooling methods are used, so far the superiority of none of them has been established. The purpose of the study is to compare two cooling methods: selective head cooling (SHC) and whole body cooling (WBC) MATERIAL AND METHODS: We conducted a prospective observational study in newborns with HIE. The patients received one of methods: SHC or WBC. The eligibility criteria were similar to previous studies. Stability of cardio-respiratory parameters and short term outcomes were analyzed. RESULTS: 78 neonates with hypoxic-ischemic encephalopathy due to perinatal asphyxia were involved in this study. The SHC group consisted of 51 newborns, the WBC group consisted of 27 patients. Both study groups had similar baseline characteristics and condition at birth. There were no significant differences in hospital course, neurological status and adverse effects associated with cooling procedure between groups. Analyzing the rate of thrombocytopenia and the number of transfusions of blood components no statistically significant differences were found between the groups. CONCLUSIONS: Results of our study indicate that two compared methods of TH despite varied target core temperature ranges do not differ significantly according to clinical course and risk of adverse events. Further observations are conducted and we look forward to the results of the long neurodevelopmental care.

Magnesium sulfate effect on erythrocyte membranes of asphyxiated newborns.

OBJECTIVES: Magnesium sulfate has been recognized as a neuroprotective agent against hypoxia-ischemia, mainly by the protection from the excitotoxicity associated with increased glutamate concentration. However, the mechanism of MgSO4 action is not fully understood and is considerably controversial. DESIGN AND METHODS: During the 2 first hours of life, the asphyxiated full-term newborns were treated intravenously with one dose of MgSO4 250 mg/kg body weight. At birth, after 6 and 48 h of life the activity of ATP-dependent enzymes in erythrocyte membranes: Mg2+-ATPase, Ca2+-ATPase, protein kinases A and C, were determined. Using monoclonal antibodies, the band 3 and its phosphotyrosine level were also assayed. RESULTS: The time-dependent decrease of Ca2+-ATPase activity was detected in untreated newborns, whereas MgSO4 prevented this reduction. After 48 h, protein kinases activities differed in MgSO4-treated and untreated groups. Magnesium therapy increased the amount of band 3 and diminished proteolytic degradation of this protein. CONCLUSION: Our results demonstrated, for the first time, that magnesium sulfate treatment significantly altered the activities of some important enzymes in erythrocyte membrane from asphyxiated newborns. It also reduced the post-asphyxial damages of membrane compounds. These data may partly explain the molecular mechanisms of MgSO4 action in asphyxiated newborns.

[Single nasal prong versus infant flow driver in very low birth weight infants: clinical efficacy of two modes of nasal continuous positive airway pressure (CPAP)]. / Porównanie skutecznosci dwóch technik donosowego CPAP; pojedynczej kaniuli donosowej vs Infant Flow Driver.

The authors compared efficacy of two different NCPAP techniques in VLBW newborn with respiratory insufficiency. Among the patients with IFD support the higher weaning rate and the lower supplemental oxygen requirement as well as secondary infections incidents was observed.

Protein kinases activities in erythrocyte membranes of asphyxiated newborns.

OBJECTIVES: Perinatal asphyxia represents a major cause of acute brain impairment and mortality in neonates. To develop the effective therapies able to reduce post-asphyxial damages, the understanding of biochemical processes accompanying asphyxia appears to be of the great relevance. DESIGN AND METHODS: The activities of protein kinases A and C, and tyrosine kinases in erythrocyte membranes of healthy and asphyxiated neonatals were compared. Using monoclonal antibodies the band 3 presence and its phosphotyrosine levels were assayed. RESULTS: In asphyxiated erythrocyte membranes the activities of PKA and tyrosine kinases increased, whereas the activity of PKC was reduced in relation to healthy newborns. Under asphyxia the band 3 has been overphosphorylated; however, its amount decreased. CONCLUSION: These findings may provide some evidence for a potential role of asphyxia in disturbance of phosphorylation processes in erythrocytes, as reflected by altered protein kinases activities. The diminished band 3 presence may be partially responsible for the impairment of erythrocyte function.