{"id":4180,"date":"2022-12-19T18:37:31","date_gmt":"2022-12-19T18:37:31","guid":{"rendered":"https:\/\/neuropediatoolbox.org\/?p=4180"},"modified":"2022-12-19T18:38:22","modified_gmt":"2022-12-19T18:38:22","slug":"hipotermia-terapeutica-neonatal","status":"publish","type":"post","link":"https:\/\/neuropediatoolkit.org\/en\/hipotermia-terapeutica-neonatal\/","title":{"rendered":"Hipotermia terap\u00e9utica neonatal."},"content":{"rendered":"\n<p>Criterios de tratamiento: <\/p>\n\n\n\n<div id=\"wp-block-themeisle-blocks-accordion-8af81570\" class=\"wp-block-themeisle-blocks-accordion exclusive\">\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Criterio A: Reci\u00e9n nacidos de m\u00e1s de 34 semanas de EG completadas con al menos 1 de los par\u00e1metros de acidosis grave: <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<ul class=\"wp-block-list\">\n<li>Apgar menor de 5 a los 5 minutos. <\/li>\n\n\n\n<li>Reanimaci\u00f3n en sala de partos durante m\u00e1s de 10 minutos, mediante ventilaci\u00f3n con presi\u00f3n positiva (mascarilla o tubo endotraqueal). <\/li>\n\n\n\n<li>pH menor de 7 en la peor gasometr\u00eda de la primera hora de vida (sangre de cord\u00f3n, arterial, venosa o capilar). <\/li>\n\n\n\n<li>D\u00e9ficit de bases mayor de 16 mmol\/L en la peor gasometr\u00eda de la primera hora de vida (sangre de cord\u00f3n, arterial, venosa o capilar). <\/li>\n<\/ul>\n\n\n\n<div id=\"wp-block-themeisle-blocks-accordion-dff3ca43\" class=\"wp-block-themeisle-blocks-accordion exclusive\"><\/div>\n<\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Criterio B. Todos los reci\u00e9n nacidos que cumplan el criterio A ser\u00e1n valorados neurol\u00f3gicamente mediante el criterio B.<\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<ul class=\"wp-block-list\">\n<li>Convulsiones. <\/li>\n\n\n\n<li>Cl\u00ednica de EHI moderada o grave: Se tienen que cumplir los 3 siguientes criterios: \n<ul class=\"wp-block-list\">\n<li>Estado de consciencia alterado (respuesta a la estimulaci\u00f3n disminu\u00edda o ausente). <\/li>\n\n\n\n<li>Tono anormal (hipoton\u00eda focal o generalizada). <\/li>\n\n\n\n<li>Reflejos primitivos anormales (succi\u00f3n d\u00e9bil\/ausente, Moro anormal, etc.). <\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Criterio C: Trazado electroencefalogr\u00e1fico. En cuanto sea posible, y al menos durante 30 minutos, se monitorizar\u00e1 la actividad con aEEG. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p>Se pueden dar dos situaciones:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>aEEG normal (CNV): en las primeras 6 horas de vida indica una alta probabilidad de pron\u00f3stico neurol\u00f3gico normal y, si la exploraci\u00f3n neurol\u00f3gica es acorde (EHI leve), se considerar\u00e1 la retirada de la hipotermia. Siempre que se pueda se deber\u00e1 contrastar con un EEG convencional. <\/li>\n\n\n\n<li>aEEG alterado: Corrobora el diang\u00f3stico de EHI moderada-grave y se debe mantener tratamiento 72 horas: \n<ul class=\"wp-block-list\">\n<li>Trazado de base normal (CNV) con convulsiones.<\/li>\n\n\n\n<li>Estatus epil\u00e9ptico. <\/li>\n\n\n\n<li>Trazado de base alterado: DNV, brote-supresi\u00f3n.<\/li>\n\n\n\n<li>Trazado de base suprimido: bajo voltaje, isoel\u00e9ctrico.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div><\/details>\n<\/div>\n\n\n\n<figure class=\"wp-block-image size-large\"><img fetchpriority=\"high\" decoding=\"async\" width=\"812\" height=\"1024\" src=\"http:\/\/neuropediaclinic.com\/wp-content\/uploads\/2022\/12\/imagen-17-812x1024.png\" alt=\"\" class=\"wp-image-4181\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/12\/imagen-17-812x1024.png 812w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/12\/imagen-17-238x300.png 238w, 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id=\"zp-ID-4180-332710-9ZFBM6U5\" data-zp-author-date='Arnaez-et-al.-2018' data-zp-date-author='2018-Arnaez-et-al.' data-zp-date='2018' data-zp-year='2018' data-zp-itemtype='journalArticle' class=\"zp-Entry zpSearchResultsItem\">\n<div class=\"csl-bib-body\" style=\"line-height: 1.35; \">\n  <div class=\"csl-entry\" style=\"clear: left; \">\n    <div class=\"csl-left-margin\" style=\"float: left; padding-right: 0.5em; text-align: right; width: 1em;\">1.<\/div><div class=\"csl-right-inline\" style=\"margin: 0 .4em 0 1.5em;\">Arnaez J, Garcia-Alix A, Calvo S, Lubi\u00e1n-L\u00f3pez S. Asistencia en Espa\u00f1a del reci\u00e9n nacido con asfixia perinatal candidato a hipotermia terap\u00e9utica durante las primeras seis horas de vida. Anales de Pediatr\u00eda [Internet]. 2018 [cited 2022 Dec 19];89(4):211\u201321. Available from: <a class='zp-ItemURL' href='https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1695403317304496'>https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1695403317304496<\/a><\/div>\n  <\/div>\n<\/div>\n\t\t\t\t<\/div><!-- .zp-Entry .zpSearchResultsItem -->\n\t\t\t<\/div><!-- .zp-zp-SEO-Content -->\n\t\t<\/div><!-- .zp-List -->\n\t<\/div><!--.zp-Zotpress-->\n\n<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Criterios de tratamiento:<\/p>","protected":false},"author":1,"featured_media":4182,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[52,8],"tags":[],"class_list":["post-4180","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-enfermedades-neuropediatricas-clasicas","category-neonatal","entry"],"_links":{"self":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/4180","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/comments?post=4180"}],"version-history":[{"count":0,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/4180\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media\/4182"}],"wp:attachment":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media?parent=4180"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/categories?post=4180"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/tags?post=4180"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}