Sokolova K. Early diagnosis and prognosis of hypoxic-ischemic central nervous system lesions in full-term infants with severe asphyxia

The dissertation is aimed to improve the early diagnostics and prediction of a hypoxic-ischemic central nervous system damage course basing on investigation of the state of cerebral venous hemodynamics and regional oxygen saturation of brain tissue in full-term newborns with severe asphyxia at birth, and on evaluation of the effectiveness of systemic therapeutic hypothermia (TH) using simple means of cooling. It is shown that TH leads to a significant reduction in the frequency of fatalities from 20.3% to 7.8% in comparison with normothermy (OR-0.330; 95% CI 0.136-0.801). It is proven that newborns with adverse outcomes of hypoxic-ischemic injury have a significantly higher blood flow velocity in the vein of Galen and higher indices of cerebral oximetry of the left frontal lobe. It was found that the onset of TH during the first hour of life is not accompanied by a significant reduction in the incidence of adverse outcomes compared with the onset of hypothermia during the second to sixth hour of life. An early prediction model for short-term adverse outcomes during TH has been developed, which includes an Apgar score at the 5th minute of life, an anterior cerebral artery resistance index, and blood flow velocity in the vein of Galen, measured at 12-24 hours of age.