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Targeted temperature management (TTM), previously known as therapeutic hypothermia or protective hypothermia, is an active treatment that tries to achieve and maintain a specific body temperature in a person for a specific duration of time in an effort to improve health outcomes during recovery after a period of stopped blood flow to the brain. [1]
Hypothermia appears to have multiple effects at a cellular level following cerebral injury. Hypothermia reduces vasogenic oedema, haemorrhage and neutrophil infiltration after trauma. [31] The release of excitatory neurotransmitters is reduced, limiting intracellular calcium accumulation.
Neonatal stroke, similar to a stroke which occurs in adults, is defined as a disturbance to the blood supply of the developing brain in the first 28 days of life. [1] This description includes both ischemic events, which results from a blockage of vessels, and hypoxic events, which results from a lack of oxygen to the brain tissue, as well as some combination of the two.
For newborn infants starved of oxygen during birth there is now evidence that hypothermia therapy for neonatal encephalopathy applied within 6 hours of cerebral hypoxia effectively improves survival and neurological outcome. [25] [26] In adults, however, the evidence is less convincing and the first goal of treatment is to restore oxygen to the ...
778 Conditions involving the integument and temperature regulation of fetus and newborn. 778.0 Hydrops fetalis not due to isoimmunization; 778.1 Sclerema neonatorum; 778.2 Cold injury syndrome of newborn; 778.3 Other hypothermia of newborn; 778.4 Other disturbances of temperature regulation of newborn; 778.5 Other and unspecified edema of newborn
Infants with hypothermia may feel cold when touched, with bright red skin and an unusual lack of energy. [ 14 ] Behavioural changes such as impaired judgement, impaired sense of time and place, unusual aggression and numbness can be observed in individuals with hypothermia, they can also deny their condition and refuse any help.
Neonatal encephalopathy (NE), previously known as neonatal hypoxic-ischemic encephalopathy (neonatal HIE or NHIE), is defined as a encephalopathy syndrome with signs and symptoms of abnormal neurological function, in the first few days of life in an infant born after 35 weeks of gestation.
Hypothermia can also prevent the injuries that occur after circulation returns to the brain, or what is termed reperfusion injuries. In fact, an individual suffering from an ischemic insult continues suffering injuries well after circulation is restored. In rats, it has been shown that neurons often die a full 24 hours after blood flow returns.