Application of Simple Head Cooling Combined with Gangliosides in Neonatal Hypoxic-ischemic Encephalopathy

Updata:01-01-1970

Source:
By:Zhen Zhan, Huanhuan Cheng, Xianhong Lin, Yangyang Meng, Liying Dai, Hong Zheng, Qilian Xie

DOI: https://doi.org/10.30564/jhp.v2i2.2666

Abstract:

Objective To investigate the effect of simple head cooling combined with ganglioside therapy on neonatal hypoxic-ischemic encephalopathy (HIE) and its clinical efficacy. Methods A total of 100 children with HIE admitted in the neonatal ward of our hospital from August 2018 to October 2020 were selected as the research objects, and were divided into control group and observation group according to the random number table method, with 50 cases in each group. The control group was treated with gangliosides, and the observation group was treated with simple head cooling combined with gangliosides. Observe and compare the clinical performance improvement time, the level of relevant hematological examination indexes before and after treatment, and the neonatal behavioral neurological assessment (NBNA), clinical efficacy, and adverse reactions. Results The improvement time of convulsions, disturbance of consciousness, pupil changes, hypotonia, and gastrointestinal dysfunction in the observation group was significantly lower than that in the control group (all P<0.001). After treatment, the NSE, IL-6, CK, CK-MB of the two groups of children were significantly lower than before treatment, and the serum calcium and NBNA scores were significantly higher than before treatment, and the decrease or increase in the observation group was significantly higher than that of the control Group (all P<0.001). The total effective rate of treatment of children in the observation group (82.00%) was higher than that of the control group (62.00%) (P<0.05). There were no obvious adverse reactions in both groups. Conclusion The simple head cooling combined with gangliosides in the treatment of HIE can improve the clinical symptoms, blood test index levels, and NBNA scores. The clinical effect is clear and superior to the single use of gangliosides.

References:

[1]Danguecan A, El Shahed AI, Somerset E, et al. Towards a biopsychosocial understanding of neurodevelopmental outcomes in children with hypoxic-ischemic encephalopathy: A mixed-methods study[J]. Clin Neuropsychol, 2020, 10(26): 1-23. [2] Garcia-Alix A, Arnaez J, Herranz-Rubia N, et al. Ten years since the introduction of therapeutic hypothermia in neonates with perinatal hypoxic-ischaemic encephalopathy in Spain[J]. Neurologia, 2020, S0213- 4853(20): 30227-9. [3] Liang SP, Chen Q, Cheng YB, et al. Comparative Effects of Monosialoganglioside versus Citicoline on Apoptotic Factor, Neurological Function and Oxidative Stress in Newborns with Hypoxic-Ischemic Encephalopathy[J]. Coll Physicians Surg Pak. 2019, 29(4): 324-327. [4] Neonatology Group of Pediatrics Branch of Chinese Medical Association. Diagnostic. criteria for neonatal hypoxic-ischemic encephalopathy[J]. Chinese Journal of Pediatrics, 2005, (08): 584. [5] Bao Xiulan. The significance of neonatal behavioral neurometry in predicting the prognosis of neonatal hypoxic-ischemic encephalopathy[J]. Chinese Journal of Practical Pediatrics, 1995(02): 84-86. [6] Popescu MR, Panaitescu AM, Pavel B, et al. Getting an Early Start in Understanding Perinatal Asphyxia Impact on the Cardiovascular System[J]. Front Pediatr, 2020, 8: 68. [7] Greco P, Nencini G, Piva I, et al. Pathophysiology of hypoxic-ischemic encephalopathy: a review of the past and a view on the future[J]. Acta Neurol Belg, 2020, 120(2): 277-288. [8] Johnston MV, Fatemi A, Wilson MA, et al. Treatment advances in neonatal neuroprotection and neurointensive care[J]. Lancet Neurol, 2011, 10(4): 372-382. [9] Parga-Belinkie J, Foglia EE, Flibotte J. Caveats of Cooling: Available Evidence and Ongoing Investigations of Therapeutic Hypothermia[J]. Neoreviews, 2019, 20(9): e513-e519. [10] Wang Q, Lv H, Lu L, et al. Neonatal hypoxic-ischemic encephalopathy: emerging therapeutic strategies based on pathophysiologic phases of the injury[J]. J Matern Fetal Neonatal Med, 2019, 32(21): 3685- 3692. [11] Nair J, Kumar VHS. Current and Emerging Therapies in the Management of Hypoxic Ischemic Encephalopathy in Neonates[J]. Children (Basel), 2018, 5(7): 99. [12] Jacobs SE, Morley CJ, Inder TE, et al. Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: a randomized controlled trial[J]. Arch Pediatr Adolesc Med, 2011, 165(8): 692-700. [13] Sheng L, Li Z. Adjuvant treatment with monosialoganglioside may improve neurological outcomes in neonatal hypoxic-ischemic encephalopathy: A meta-analysis of randomized controlled trials[J]. PLoS One, 2017, 12(8): e0183490. [14] León-Lozano MZ, Arnaez J, Valls A, et al. Cerebrospinal fluid levels of neuron-specific enolase predict the severity of brain damage in newborns with neonatal hypoxic-ischemic encephalopathy treated with hypothermia[J]. PLoS One, 2020, 15(6): e0234082. [15] Go H, Saito Y, Maeda H, et al. Serum cytokine profiling in neonates with hypoxic ischemic encephalopathy[J]. J Neonatal Perinatal Med, 2020, 10.3233/ NPM-200431. [16] Vayalthrikkovil S, Bashir R, Espinoza M, et al. Serum calcium derangements in neonates with moderate to severe hypoxic ischemic encephalopathy and the impact of therapeutic hypothermia: a cohort study[J]. J Matern Fetal Neonatal Med, 2020, 33(6): 935-940. [17] Bhasin H, Kohli C. Myocardial dysfunction as a predictor of the severity and mortality of hypoxic ischaemic encephalopathy in severe perinatal asphyxia: a case-control study[J]. Paediatr Int Child Health, 2019, 39(4): 259-264. [18] Balduini W, Weiss MD, Carloni S, et al. Melatonin pharmacokinetics and dose extrapolation after enteral infusion in neonates subjected to hypothermia[J]. J Pineal Res, 2019, 66(4): e12565.

Tags: