Arnaez Juan, Miranda María, Riñones Ester, García-Alix Alfredo
1 Neonatal Unit, Hospital Universitario de Burgos, Burgos, Spain.
2 Fundación NeNe, Spain.
Ther Hypothermia Temp Manag. 2019 Jun;9(2):159-162. doi: 10.1089/ther.2018.0042. Epub 2019 Jan 2.
There is mounting experimental evidence that therapeutic hypothermia (TH) mitigates secondary mechanisms of spinal cord injury (SCI). There is a potential synergistic neuroprotective effect for SCI through the combination of TH and other promising therapies. The treatment of TH for SCI has promising results in adults, but its use is anecdotal in newborns with SCI. SCI is a rare, serious, and often fatal complication of instrumental delivery. For the first time, we describe the case of a male newborn infant with upper SCI who was born at term age and was offered whole-body cooling and erythropoietin treatment with unsuccessful outcome. There are still many unresolved issues related to TH in the SCI, some of them specific to the neonatal patient. Accurately establishing the diagnosis and its severity is crucial to redirect care for SCI and to indicate potential neuroprotective therapies. Considering the lack of therapeutic options, the extremely poor outcomes associated with acute SCI, and the extensive experience in safe use of whole-body cooling in newborn infants, we feel that moderate whole-body cooling should be offered as soon as possible after birth to the newborn infant with SCI.
越来越多的实验证据表明，治疗性低温（TH）可减轻脊髓损伤（SCI）的继发性机制。通过TH与其他有前景的疗法联合使用，对SCI可能存在协同神经保护作用。TH治疗成人SCI已取得了有前景的结果，但其在新生儿SCI中的应用仅为个案报道。SCI是器械助产的一种罕见、严重且常致命的并发症。我们首次描述了一名足月出生的男性新生儿患有上位SCI的病例，该患儿接受了全身降温及促红细胞生成素治疗，但未取得成功。在SCI中，与TH相关的许多问题仍未得到解决，其中一些问题是新生儿患者所特有的。准确确立诊断及其严重程度对于重新调整SCI的治疗及指明潜在的神经保护疗法至关重要。鉴于缺乏治疗选择、急性SCI相关的极差预后以及在新生儿安全使用全身降温方面的丰富经验，我们认为对于患有SCI的新生儿，应在出生后尽快给予适度的全身降温治疗。
