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Decreasing neurologic injury in children after hypoxic injury: Is transcutaneous doppler the way to go?

  • Maryam Y. Naim
    Affiliations
    The Cardiac Center, The Children’s Hospital of Philadelphia, Departments of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

    Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
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  • Joseph W. Rossano
    Correspondence
    Corresponding author at: The Cardiac Center, The Children’s Hospital of Philadelphia, Departments of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, United States.
    Affiliations
    The Cardiac Center, The Children’s Hospital of Philadelphia, Departments of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
    Search for articles by this author
      Poor neurologic outcomes in children after a neurologic insult from hypoxic ischemic injury (HII) continues to be an important and challenging issue. It is not clear what interventions can be done after the injury to improve long-term neurologic outcomes. In the Therapeutic Hypothermia after Pediatric Cardiac Arrest Trials, both the in-hospital and out-of-hospital cardiac arrest groups demonstrated no benefit of survival with a favorable neurobehavorial outcome with the use of therapeutic hypothermia [
      • Moler F.W.
      • Silverstein F.S.
      • Holubkov R.
      • et al.
      Therapeutic hypothermia after in-hospital cardiac arrest in children.
      ,
      • Moler F.W.
      • Silverstein F.S.
      • Holubkov R.
      • et al.
      Therapeutic hypothermia after out-of-hospital cardiac arrest in children.
      ]. In the out-of-hospital arrest cohort, only 16% of patients with baseline good neurologic function were alive with good neurologic outcome 1-year after the cardiac arrest [
      • Moler F.W.
      • Silverstein F.S.
      • Holubkov R.
      • et al.
      Therapeutic hypothermia after out-of-hospital cardiac arrest in children.
      ]. Consequently, it is critically important to develop interventions that can reduce the burden of neurologic injury in children after HII.
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