Chapter 28 - Hemodynamics in the Asphyxiated Neonate and Effects of Therapeutic Hypothermia

Abstract

Hypoxic-ischemic injury secondary to asphyxia is a common cause of brain injury in neonates, affecting 1 to 3 infants per 1000 live births. Infants with moderate to severe hypoxic-ischemic injury often have cardiovascular instability and myocardial dysfunction affecting organ perfusion and thus oxygen delivery, which can potentially result in further injury if not identified in a timely manner. Pulmonary hypertension can further complicate the postnatal course. Cerebral autoregulation, often severely impaired by the underlying pathophysiology, can further be affected by therapeutic hypothermia (TH) and rewarming, which in turn can lead to reperfusion injury to the brain. These hemodynamic complications might affect long-term outcomes.