Annually, approximately one million neonatal deaths happen at birth and soon after that are related to asphyxia and its complications. Transition facilitation and neonatal resuscitation are important measures to improve the outcome of these critically ill neonates. We thus propose this Research Topic to provide up-to-date and current state-of-the-art knowledge on the interventions and on-going care to the asphyxiated neonates.
Neonatal asphyxia differs in the pathogenesis of asphyxia from that of other patient populations, as it is primarily related to respiratory failure. Therefore, various ventilatory interventions to correct respiratory failure have been studied if they can facilitate the transition or improve recovery with minimal adverse effects on other systems. The latter refer to the multi-systems and multi-organs dysfunction including cerebral, cardiac, respiratory, intestinal and renal dysfunction which commonly occur in almost 80% of asphyxiated neonates.
Among the interventions, oxygen use is one of them that has a unique role in these neonates in fetal-neonatal transition and differs from those in other more mature clinical populations. The observation of changes in systemic and regional (cerebral) oxygenation helps better understanding of the fetal-neonatal transition as well as the use of oxygen. Based on the evidence from clinical and biomedical studies, the use of room air in the resuscitation of preterm and term neonates has become the standard practice since 2010. Recently, multi-centre clinical trials are in progress to examine the cautious use of oxygen in the resuscitation of extremely preterm neonates. Similarly, therapeutic hypothermia, an evidence-based intervention that has been shown to improve the early childhood neurodevelopmental outcome of asphyxiated neonates of near-term and term gestation, has been the standard care in many centres since 2005. However, questions remain on the therapeutic window of its use including the time, duration, depth and clinical population. Further in this “cool” topic of neuroprotective strategy, there are “hot” studies on-going to search for effective adjunctive therapies that can improve the outcome of neonates with moderate and severe hypoxic-ischemic encephalopathy.
This proposal provides a platform for dissemination of recent advances and state-of-the-art knowledge of neonatal resuscitation and the interventions. The topic includes but is not limited to studies in the pathophysiology of asphyxia, hypoxic-reoxygenation injury of neurologic, cardiac, pulmonary and other systems/organs, the resuscitation and novel interventions of asphyxiated neonates, and up-to-date knowledge of the outcome and ongoing care of surviving children. All kinds of studies will be considered including biomedical, population, qualitative, simulation and educational studies as well as meta-analyses and reviews.
Annually, approximately one million neonatal deaths happen at birth and soon after that are related to asphyxia and its complications. Transition facilitation and neonatal resuscitation are important measures to improve the outcome of these critically ill neonates. We thus propose this Research Topic to provide up-to-date and current state-of-the-art knowledge on the interventions and on-going care to the asphyxiated neonates.
Neonatal asphyxia differs in the pathogenesis of asphyxia from that of other patient populations, as it is primarily related to respiratory failure. Therefore, various ventilatory interventions to correct respiratory failure have been studied if they can facilitate the transition or improve recovery with minimal adverse effects on other systems. The latter refer to the multi-systems and multi-organs dysfunction including cerebral, cardiac, respiratory, intestinal and renal dysfunction which commonly occur in almost 80% of asphyxiated neonates.
Among the interventions, oxygen use is one of them that has a unique role in these neonates in fetal-neonatal transition and differs from those in other more mature clinical populations. The observation of changes in systemic and regional (cerebral) oxygenation helps better understanding of the fetal-neonatal transition as well as the use of oxygen. Based on the evidence from clinical and biomedical studies, the use of room air in the resuscitation of preterm and term neonates has become the standard practice since 2010. Recently, multi-centre clinical trials are in progress to examine the cautious use of oxygen in the resuscitation of extremely preterm neonates. Similarly, therapeutic hypothermia, an evidence-based intervention that has been shown to improve the early childhood neurodevelopmental outcome of asphyxiated neonates of near-term and term gestation, has been the standard care in many centres since 2005. However, questions remain on the therapeutic window of its use including the time, duration, depth and clinical population. Further in this “cool” topic of neuroprotective strategy, there are “hot” studies on-going to search for effective adjunctive therapies that can improve the outcome of neonates with moderate and severe hypoxic-ischemic encephalopathy.
This proposal provides a platform for dissemination of recent advances and state-of-the-art knowledge of neonatal resuscitation and the interventions. The topic includes but is not limited to studies in the pathophysiology of asphyxia, hypoxic-reoxygenation injury of neurologic, cardiac, pulmonary and other systems/organs, the resuscitation and novel interventions of asphyxiated neonates, and up-to-date knowledge of the outcome and ongoing care of surviving children. All kinds of studies will be considered including biomedical, population, qualitative, simulation and educational studies as well as meta-analyses and reviews.