AI Article Synopsis
- Therapeutic hypothermia has been shown to reduce death and severe disability risks in infants with neonatal encephalopathy and is becoming a standard treatment in some regions.
- In India, while some neonatal units are exploring this treatment, there are important ethical considerations due to differences in the local context and possible ineffectiveness or risks associated with cooling.
- Conducting large clinical trials in India could provide answers, but these trials would also raise ethical dilemmas related to treatment decisions, prognosis uncertainty, and limited neonatal intensive care resources.
Article Abstract
Trials in developed countries have shown that therapeutic hypothermia reduces the risk of death or severe disability in infants with neonatal encephalopathy. Cooling has been adopted as a standard of care in some parts of the world. Some Indian neonatal units have considered or even embarked upon cooling encephalopathic term newborn infants. In this article we discuss some of the potential ethical questions that should be considered before introducing therapeutic hypothermia in an Indian setting. Evidence from previous trials may not be relevant given significant differences in the epidemiology of neonatal encephalopathy in countries like India. There is a possibility that hypothermia would be ineffective or harmful. The most appropriate way to answer these concerns would be to perform a large randomized controlled trial of cooling in India. However, such trials will also raise potential ethical challenges. Cooling may also affect decisions about treatment withdrawal, and may create uncertainty about prognosis. It may exacerbate ethical problems relating to lack of neonatal intensive care bed space.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s13312-010-0074-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Histone acetylation alteration by KAT6A inhibitor WM-1119 suppresses IgE-mediated mast cell activation and allergic inflammation via reduction in AP-1 signaling.
Biochem Pharmacol
December 2024
Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shenzhen University Medical School, Shenzhen University, Shenzhen 518055, China. Electronic address:
Activation of immunoglobulin E (IgE)-associated mast cells (MCs) triggers the onset of pro-inflammatory signals associated with type I allergic diseases. Although histone acetylation changes have been associated with inflammatory diseases, the impact of lysine-acetyltransferase (KAT) inhibitors on IgE-mediated MCs function is unclear. Potential anti-allergic effects of the KAT6A inhibitor WM-1119 on IgE-mediated MCs activation and allergic inflammation were examined in this study.
View Article and Find Full Text PDFApplication of high-quality targeted temperature management guided by multimodal brain monitoring in brain protection of patients with cardiac arrest: A case series.
Medicine (Baltimore)
December 2024
Department of Intensive Care Medicine, Xiangya Hospital, Central South University, Changsha, China.
Rationale: Cardiac arrest (CA) is an acute emergency with high mortality and is closely associated with the risk of brain damage or systemic ischemia-reperfusion injury, post-traumatic stress symptoms.
Patient Concerns: Targeted temperature management in the intensive care unit can improve the neurological outcomes of patients who are comatose after resuscitation from CA. However, there is often a lack of specific evaluation methods for optimal target temperature settings.
Hypothermia improves neuronal network recovery in a human-derived in vitro model of oxygen-deprivation.
PLoS One
December 2024
Department of Clinical Neurophysiology, University of Twente, Enschede, The Netherlands.
Mild therapeutic hypothermia showed potential neuroprotective properties during and after cerebral hypoxia or ischemia in experimental animal studies. However, in clinical trials, where hypothermia is mainly applied after reperfusion, results were divergent and neurophysiological effects unclear. In our current study, we employed human-derived neuronal networks to investigate how treatment with hypothermia during hypoxia influences neuronal functionality and whether it improves post-hypoxic recovery.
View Article and Find Full Text PDFEffects of intermittent hand-foot hypothermia therapy on chemotherapy-induced peripheral neurotoxicity.
Support Care Cancer
December 2024
Tangshan People's Hospital, Tangshan, 063000, China.
Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect in patients with breast cancer undergoing chemotherapy. This study aimed to assess the effects of three different intermittent hypothermia temperatures applied to the hands and feet on CIPN symptoms in patients with breast cancer undergoing chemotherapy.
Methods: In total, 108 patients were randomly divided into three experimental groups (n = 36).
Uneven Distribution of Purkinje Cell Injury in the Cerebellar Vermis of Term Neonates with Hypoxic-Ischemic Encephalopathy.
Cerebellum
December 2024
Department of Neonatology, UMC Utrecht Brain Center, University Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands.
In term neonates with hypoxic-ischemic encephalopathy (HIE), cerebellar injury is becoming more and more acknowledged. Animal studies demonstrated that Purkinje cells (PCs) are especially vulnerable for hypoxic-ischemic injury. In neonates, however, the extent and pattern of PC injury has not been investigated.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!