Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 1. P. 31–37
DIAGNOSTIC RADIOLOGY
DOI: 10.12737/article_5c55fc2cb98140.01495008
N.S. Vorotyntseva, V.V. Orlova
Radiation Examination of Newborns with General Therapeutic Hypothermia
Kursk State Medical University, Kursk Regional Perinatal Center, Kursk, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
N.S. Vorotyntseva – Head of Dep., Dr. Sci. Med., Prof.;
V.V. Orlova – Junior Researcher
Abstract
Purpose: Revealing the features of the parenchymal organs of newborns subjected to general non-invasive therapeutic hypothermia (GNTН) and the development of radiation monitoring for such patients.
Material and methods: Under our supervision were 69 children with a severe degree of perinatal asphyxia, born from January 2014 to April 2018 in the Kursk Regional Perinatal Center. In the first hours of life, 50 patients were initiated GNTH, expressed in a decrease in body temperature to 34 °C in the rectum. Hypothermia was not performed 19 newborns for objective reasons. All children underwent radiation examination, including ultrasound of the brain, heart and internal organs, chest x-ray.
Results and discussion: The study revealed a high neuroprotective effect (assessed by ultrasound) of general non-invasive therapeutic hypothermia, depending on the Apgar score at the 5th minute of life: 66.7 % of children had a normal ultrasound pattern of the brain with the 21st day ≥4 points and received GNTH, 50 % of children ≤ 3 points after therapeutic hypothermia and 36.8 % of newborns without GNTH (p ≤ 0.001). The complex 5-step radiation monitoring, which included chest x-ray, ultrasound of the brain, heart and internal organs (liver, pancreas, spleen, kidneys, adrenals), revealed the features of neonatal period in children in the background GNTH: increased risk of development of parenchymal hemorrhages on the 3rd day and postnatal pneumonia on the 7th day of life.
Conclusion: A complex stage radiological examination of newborns in need of GNTH is the key to timely effective diagnosis, prevention and treatment of severe pathological conditions of the neonatal period.
Key words: newborns, asphyxia of severe degree, general therapeutic hypothermia, radiation monitoring
REFERENCES
1. Medico-Demographic Indicators of the Russian Federation in 2014. Moscow. 2015. 186 p. (Russian).
2. Baranov AA, Ilyin AG, Konova SR, Antonova EV. Ways to improve the quality and accessibility of medical care for children in primary care. Questions of Modern Pediatrics. 2009;4(8):5-8. (Russian).
3. Jacobs SE, Morley CJ, Inder TE, et al. Infant Cooling Evaluation Collaboration. Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: a randomized controlled trial. Arch Pediatr Adolesc Med. 2011;165(8):692-700.
4. TOBY Protocol and Handbook. 2009. Available at: https: www.npeu.ox.ac.uk./tobyregister/docs. (accessed 25 October 2015).
5. Robertson NJ, Nakakeeto M, Hagmann С, et al. Therapeutic hypothermia for birth asphyxia in low-resource settings: a pilot randomised controlled trial. Lancet. 2008;372(9641):801-3.
6. Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ishaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 2004;89:152-5.
7. Ionov OV. The protocol of medical hypothermia of children born in asphyxia. Neonatology. 2014;2:43-5. (Russian).
8. Edwards AD, Brocklehurst P, Gunn AJ, et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischemic encephalopathy: synthesis and meta-analysis of trial data. BMJ. 2010;9:340-63.
9. Grigoryev EV, Shukevich DL, Plotnikov GP, Tikhonov NS. Therapeutic hypothermia: possibilities and prospects. Clinical Medicine. 2014;9:9-16. (Russian).
For citation: Vorotyntseva NS, Orlova VV. Radiation Examination of Newborns with General Therapeutic Hypothermia. Medical Radiology and Radiation Safety. 2019;64(1):31-7. (Russian).
PDF (RUS) Full-text article (in Russian)