Hypothermia and Cardiovascular Instability

Clin Perinatol. 2020 Sep;47(3):575-592. doi: 10.1016/j.clp.2020.05.012. Epub 2020 May 21.

Abstract

Severely asphyxiated neonates have acute heart failure as part of their multiorgan dysfunction syndrome during the first days of life. Supporting the cardiovascular system during this phase is part of contemporary treatment and regarded as vital for limiting the neurodevelopmental injury. The decision to treat cardiovascular instability should be based on evaluation of end-organ function. Neonatologist-performed echocardiography in combination with other diagnostic modalities enables comprehensive real-time assessment. This review discusses associations between hemodynamics and adverse outcome, modalities for evaluating the hemodynamic state of the infant, and therapeutic approaches during intensive care.

Keywords: Hypoxic ischemic encephalopathy; Neonatologist-performed echocardiography; Perinatal asphyxia.

Publication types

  • Review

MeSH terms

  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / physiopathology
  • Asphyxia Neonatorum / therapy*
  • Cardiac Output / physiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology*
  • Cerebrovascular Circulation
  • Echocardiography
  • Heart / diagnostic imaging
  • Heart Rate
  • Humans
  • Hypothermia, Induced / adverse effects
  • Hypothermia, Induced / methods*
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / physiopathology
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Myocardial Contraction
  • Stroke Volume
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology