Therapeutische Hypothermiebehandlung bei Neugeborenen mit hypoxisch-ischämischer Enzephalopathie

Einleitung

Die perinatale Asphyxie ist die Folge eines gestörten plazentaren oder pulmonalen Gasaustauschs. Der gestörte Gasaustausch führt zu Hypoxie und Hyperkapnie, welche die Umstellung auf anaerobe Glukolyse und die Laktatproduktion zur Folge hat. Patienten, die eine perinatale Asphyxie erlitten haben, laufen Gefahr, eine hypoxisch-ischämische Enzephalopathie (HIE) zu entwickeln. Der bisher einzige klinisch etablierte therapeutische Ansatz zur Verminderung der neurologischen Spätfolgen und der Mortalität nach HIE ist die Hypothermiebehandlung. Dank mehrerer großer kontrolliert-randomisierter Studien konnte die therapeutische Hypothermie 2010 als Behandlungsstandard für reife Neugeborene nach perinataler Asphyxie mit moderater bis schwerer HIE etabliert werden [1]. Eine Metaanalyse bestätigte die Reduktion des kombinierten Outcomes Mortalität oder Behinderung im Alter von 18 bis 24 Monaten durch die Hypothermiebehandlung um 25 % [2].

• Literatur

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