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A term newborn was born via emergency cesarean section in the setting of fetal bradycardia. The baby was limpand bradycardic at birth and was intubated at 6 minutes
after birth for persistent apnea. The cord blood gas demonstrates a severe metabolic acidosis, and the physical examination is consistent with hypoxic-ischemic
encephalopathy (HIE). Which of the following is the most appropriate intervention for this newborn?

Respuesta :

Among the postnatal care currently offered, therapeutic hypothermia has been shown to be a safe and effective method in reducing mortality, motor and cognitive sequelae.

Therapeutic hypothermia

The purpose of therapeutic hypothermia is to establish guidelines for the safe and effective performance of therapeutic hypothermia in neonates with moderate and severe hypoxic-ischemic encephalopathy, based on recent clinical trials, reviews and meta-analyses.

PRESCRIPTION

  • Ventilatory support necessary for the case. The heating of humidified gases must be maintained.
  • Ensure central venous access for infusion of medications, hydration and for collection of blood testsblood (umbilical venous and arterial catheterization), as there is difficulty in peripheral venous access and blood collection by peripheral vasoconstriction triggered by hypothermia.

With this information, we can conclude that the patient with hypoxic-ischemic encephalopathy (HIE) is advised to use therapeutic hypothermia.

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