Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia
Background: To assess changes in clinical condition and oxygenation in neonates after rewarming following moderate therapeutic hypothermia (MTH) for neonatal encephalopathy. Methods: Retrospective study of 28 neonates receiving MTH in a tertiary neonatal intensive care unit in Israel. We compared pr...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-08-01
|
| Series: | Pediatrics and Neonatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957218301773 |
| _version_ | 1811235626404544512 |
|---|---|
| author | Itamar Nitzan Shmuel Goldberg Cathy Hammerman Alona Bin-Nun Ruben Bromiker |
| author_facet | Itamar Nitzan Shmuel Goldberg Cathy Hammerman Alona Bin-Nun Ruben Bromiker |
| author_sort | Itamar Nitzan |
| collection | DOAJ |
| description | Background: To assess changes in clinical condition and oxygenation in neonates after rewarming following moderate therapeutic hypothermia (MTH) for neonatal encephalopathy. Methods: Retrospective study of 28 neonates receiving MTH in a tertiary neonatal intensive care unit in Israel. We compared pre-and 24 h post-rewarming arterial oxygen saturation (SaO2) as measured by the blood gases analyzer, pulse-oximetry saturation (SpO2), and cardio-respiratory condition. Results: The SpO2 declined from 96.9% (±2.9) before rewarming to 95.2% (±2.6) after rewarming (p < 0.001). Twelve neonates (42.9%) had clinical respiratory impairment (needing higher respiratory support or had new onset desaturations). In 16 neonates (57.1%) with no change in respiratory support after rewarming, SpO2 decreased from 98.3 ± 1.9% to 95.6 ± 3.0% (p < 0.001) and SaO2 decreased from 97.1 ± 1.7% to 96.0 ± 2.3% (p = 0.002). The mean SpO2 decrease was greater than mean SaO2 decrease (2.63 ± 1.8 and 1.1 ± 1.3 respectively, p = 0.021). Conclusion: Neonates who underwent MTH showed reduction in oxygenation after rewarming either by decreasing SpO2 or increasing FiO2 requirements. The SpO2 decline was larger than the SaO2 decline. We suggest careful monitoring of neonates after rewarming. Keywords: Asphyxia, Cooling, Rewarming, Hemoglobin-oxygen dissociation, Neuroprotection |
| first_indexed | 2024-04-12T11:55:13Z |
| format | Article |
| id | doaj.art-c47a43df8999471bbe0035b346ee55ad |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-04-12T11:55:13Z |
| publishDate | 2019-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-c47a43df8999471bbe0035b346ee55ad2022-12-22T03:34:02ZengElsevierPediatrics and Neonatology1875-95722019-08-01604423427Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermiaItamar Nitzan0Shmuel Goldberg1Cathy Hammerman2Alona Bin-Nun3Ruben Bromiker4Neonatology Department, Shaare Zedek Medical Center, Jerusalem, Israel; Corresponding author. Pediatric department, Shaare Zedek Medical Center, Jerusalem 9103102, Israel. Fax: +972 2666 6761.Pediatric Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, IsraelNeonatology Department, Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, IsraelNeonatology Department, Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, IsraelNeonatology Department, Shaare Zedek Medical Center, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, IsraelBackground: To assess changes in clinical condition and oxygenation in neonates after rewarming following moderate therapeutic hypothermia (MTH) for neonatal encephalopathy. Methods: Retrospective study of 28 neonates receiving MTH in a tertiary neonatal intensive care unit in Israel. We compared pre-and 24 h post-rewarming arterial oxygen saturation (SaO2) as measured by the blood gases analyzer, pulse-oximetry saturation (SpO2), and cardio-respiratory condition. Results: The SpO2 declined from 96.9% (±2.9) before rewarming to 95.2% (±2.6) after rewarming (p < 0.001). Twelve neonates (42.9%) had clinical respiratory impairment (needing higher respiratory support or had new onset desaturations). In 16 neonates (57.1%) with no change in respiratory support after rewarming, SpO2 decreased from 98.3 ± 1.9% to 95.6 ± 3.0% (p < 0.001) and SaO2 decreased from 97.1 ± 1.7% to 96.0 ± 2.3% (p = 0.002). The mean SpO2 decrease was greater than mean SaO2 decrease (2.63 ± 1.8 and 1.1 ± 1.3 respectively, p = 0.021). Conclusion: Neonates who underwent MTH showed reduction in oxygenation after rewarming either by decreasing SpO2 or increasing FiO2 requirements. The SpO2 decline was larger than the SaO2 decline. We suggest careful monitoring of neonates after rewarming. Keywords: Asphyxia, Cooling, Rewarming, Hemoglobin-oxygen dissociation, Neuroprotectionhttp://www.sciencedirect.com/science/article/pii/S1875957218301773 |
| spellingShingle | Itamar Nitzan Shmuel Goldberg Cathy Hammerman Alona Bin-Nun Ruben Bromiker Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia Pediatrics and Neonatology |
| title | Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia |
| title_full | Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia |
| title_fullStr | Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia |
| title_full_unstemmed | Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia |
| title_short | Effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia |
| title_sort | effect of rewarming in oxygenation and respiratory condition after neonatal exposure to moderate therapeutic hypothermia |
| url | http://www.sciencedirect.com/science/article/pii/S1875957218301773 |
| work_keys_str_mv | AT itamarnitzan effectofrewarminginoxygenationandrespiratoryconditionafterneonatalexposuretomoderatetherapeutichypothermia AT shmuelgoldberg effectofrewarminginoxygenationandrespiratoryconditionafterneonatalexposuretomoderatetherapeutichypothermia AT cathyhammerman effectofrewarminginoxygenationandrespiratoryconditionafterneonatalexposuretomoderatetherapeutichypothermia AT alonabinnun effectofrewarminginoxygenationandrespiratoryconditionafterneonatalexposuretomoderatetherapeutichypothermia AT rubenbromiker effectofrewarminginoxygenationandrespiratoryconditionafterneonatalexposuretomoderatetherapeutichypothermia |