治療基準:
基準 A: 重度のアシドーシス パラメータのうち少なくとも 1 つを備えた GA を完了した 34 週を超えた新生児:
- アプガーは5分で5未満。
- 陽圧換気(マスクまたは気管内チューブ)を使用した分娩室での10分以上の蘇生。
- 生後1時間の最悪のガスメトリー(臍帯血、動脈血、静脈血、または毛細管血)でpHが7未満。
- 生後1時間の最悪の血液ガス分析(臍帯血、動脈血、静脈血、または毛細管血)で16 mmol/Lを超える塩基欠乏。
基準 B. 基準 A を満たすすべての新生児は、基準 B を使用して神経学的評価を受けます。
- 発作。
- 中等度または重度の HIE 症状: 次の 3 つの基準を満たす必要があります。
- 意識状態の変化(刺激に対する反応の低下または消失)。
- 異常な緊張(局所的または全身性の低緊張)。
- 原始反射の異常(吸引力が弱い・ない、モロ異常など)。
基準 C: 脳波追跡。できるだけ早く、少なくとも 30 分間、aEEG で活動を監視します。
次の 2 つの状況が発生する可能性があります。
- 正常な aEEG (CNV): 生後 6 時間以内は正常な神経学的予後である可能性が高いことを示しており、神経学的検査が一貫している場合 (軽度の HIE)、低体温療法の中止が検討されます。可能な限り、従来の EEG と対比する必要があります。
- aEEG の変化: 中等度から重度の HIE の診断が裏付けられ、治療は 72 時間継続する必要があります。
- 発作を伴う正常なベースライン追跡 (CNV)。
- 重積てんかん。
- 塩基追跡の変更: DNV、発生抑制。
- 抑制されたベーストレース: 低電圧、等電性。

19955111
{19955111:QL4US6UJ}
1
バンクーバー
50
デフォルト
4180
https://neuropediatoolkit.org/wp-content/plugins/zotpress/
%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22QL4US6UJ%22%2C%22library%22%3A%7B%22id%22%3A19955111%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Arnaez%20et%20al.%22%2C%22parsedDate%22%3A%222018%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BArnaez%20J%2C%20Garcia-Alix%20A%2C%20Calvo%20S%2C%20Lubi%26%23xE1%3Bn-L%26%23xF3%3Bpez%20S.%20Asistencia%20en%20Espa%26%23xF1%3Ba%20del%20reci%26%23xE9%3Bn%20nacido%20con%20asfixia%20perinatal%20candidato%20a%20hipotermia%20terap%26%23xE9%3Butica%20durante%20las%20primeras%20seis%20horas%20de%20vida.%20Anales%20de%20Pediatr%26%23xED%3Ba%20%5BInternet%5D.%202018%20%5Bcited%202022%20Dec%2019%5D%3B89%284%29%3A211%26%23x2013%3B21.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Flinkinghub.elsevier.com%5C%2Fretrieve%5C%2Fpii%5C%2FS1695403317304496%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Flinkinghub.elsevier.com%5C%2Fretrieve%5C%2Fpii%5C%2FS1695403317304496%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Asistencia%20en%20Espa%5Cu00f1a%20del%20reci%5Cu00e9n%20nacido%20con%20asfixia%20perinatal%20candidato%20a%20hipotermia%20terap%5Cu00e9utica%20durante%20las%20primeras%20seis%20horas%20de%20vida%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Juan%22%2C%22lastName%22%3A%22Arnaez%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Alfredo%22%2C%22lastName%22%3A%22Garcia-Alix%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sara%22%2C%22lastName%22%3A%22Calvo%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sim%5Cu00f3n%22%2C%22lastName%22%3A%22Lubi%5Cu00e1n-L%5Cu00f3pez%22%7D%5D%2C%22abstractNote%22%3A%22Introduction%3A%20The%20process%20of%20care%20and%20assistance%20from%20birth%20to%20the%20starting%20of%20therapeutic%20hypothermia%20%28TH%29%20is%20crucial%20in%20order%20to%20improve%20its%20effectiveness%20and%20prevent%20the%20worsening%20of%20hypoxic-ischaemic%20injury.%5CnMethods%3A%20A%20national%20cross-sectional%20study%20carried%20out%20in%202015%20by%20use%20of%20a%20questionnaire%20sent%20to%20all%20level%20iii%20units%20on%20the%20care%20of%20the%20newborn%20%5Cu2265%2035%20weeks%20gestation%20within%20the%20%5Cufb01rst%20hours%20of%20life%20after%20a%20perinatal%20asphyxia%20event.%20According%20to%20clinical%20practice%20guidelines%2C%20the%20quality%20of%20care%20was%20compared%20between%20the%20hospitals%20that%20carried%20out%20or%20did%20not%20carry%20out%20TH%2C%20and%20according%20to%20the%20level%20of%20care.%5CnResults%3A%20A%20total%20of%2089%5C%2F90%20hospitals%20participated%2C%20of%20which%2057%5C%2F90%20performed%20TH.%20They%20all%20used%20resuscitation%20protocols%20and%20turned%20off%20the%20radiant%20warmer%20after%20stabilisation.%20All%20of%20them%20performed%20glucose%20and%20blood%20gas%20analysis%2C%20monitored%20the%20central%20temperature%2C%20put%20the%20newborn%20on%20a%20diet%2C%20and%20performed%20at%20least%20two%20examinations%20for%20the%20diagnosis%20of%20hypoxic-ischaemic%20encephalopathy.%20Greater%20than%20one-third%20%2835%25%29%20of%20hospitals%20did%20not%20have%20amplitude-integrated%20electroencephalogram%2C%20and%206%5C%2F57%20were%20TH-hospitals.%20The%20quality%20of%20care%20among%20hospitals%20with%20and%20without%20TH%20was%20similar%2C%20childbirth%20being%20better%20in%20those%20that%20performed%20TH%2C%20and%20those%20with%20a%20higher%20level%20of%20care.%20Level%20IIIc%20hospitals%20had%20higher%20scores%20than%20the%20others.%20The%20TH-hospitals%20mentioned%20not%20always%20having%20neonatologists%20with%20experience%20in%20neurological%20assessment%20and%20interpretation%20of%20amplitude-integrated%20electroencephalogram%20%2825%25%29%2C%20or%20in%20brain%20ultrasound%20%2862%25%29.%5CnConclusions%3A%20In%20response%20to%20the%20recommendations%20of%20the%20asphyxiated%20newborn%2C%20there%20is%20a%20proper%20national%20health%20care%20standard%20with%20differences%20according%20to%20the%20level%20of%20care%20and%20whether%20TH%20is%20offered.%20More%20amplitude-integrated%20electroencephalogram%20devices%20are%20necessary%2C%20as%20well%20as%20more%20neonatologists%20trained%20in%20the%20evaluations%20that%20will%20be%20require%20by%20the%20newborn%20with%20hypoxic-ischaemic%20encephalopathy.%22%2C%22date%22%3A%2210%5C%2F2018%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%2210.1016%5C%2Fj.anpedi.2017.11.003%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22https%3A%5C%2F%5C%2Flinkinghub.elsevier.com%5C%2Fretrieve%5C%2Fpii%5C%2FS1695403317304496%22%2C%22PMID%22%3A%22%22%2C%22PMCID%22%3A%22%22%2C%22ISSN%22%3A%2216954033%22%2C%22language%22%3A%22es%22%2C%22collections%22%3A%5B%22F3H4DBMI%22%5D%2C%22dateModified%22%3A%222026-05-05T17%3A03%3A21Z%22%7D%7D%5D%7D
1.
Arnaez J、Garcia-Alix A、Calvo S、Lubán-López S. 生後 6 時間の治療的低体温療法の候補となる周産期仮死の新生児をスペインでケア。小児科年報 [インターネット]。 2018 [2022 年 12 月 19 日引用];89(4):211–21。以下から入手可能: https://linkinghub.elsevier.com/retrieve/pii/S1695403317304496
