Nutrition and management of glycemia in neonates with neonatal encephalopathy treated with hypothermia.

E F Pinchefsky, J Schneider, S Basu, E W Y Tam, C Gale

Journal: Seminars in fetal & neonatal medicine 2022;26(4):101268

PMID: 34301501

Full Text on Elsevier Science View on PubMed

Abstract

Adequate nutrition and glycemic homeostasis are increasingly recognized as potentially neuroprotective for the developing brain. In the context of hypoxia-ischemia, evidence is scarce regarding optimal nutritional support and administration route, as well as the short- and long-term consequences of such interventions. In this review, we summarize current knowledge on disturbances of brain metabolism of glucose and substrates by hypoxia-ischemia, and compound effects of these mechanisms on brain injury characterized by specific patterns on EEG and MRI. Risks and benefits of nutrition delivery via parenteral or enteral routes are examined. Nutrition could mitigate adverse neurodevelopmental outcomes, and the impact of nutritional strategies and specific nutritional interventions are reviewed. Limited literature highlights the need for further studies to understand the changes in energy metabolism during and after hypoxic-ischemic injury, to optimize nutritional regimens and glucose management, and to inform the neuroprotective role of nutrition.

Address: Division of Neurology, Department of Paediatrics, CHU Sainte-Justine, University of Montréal, CHU Sainte-Justine Research Center, Department of Neurosciences, Montreal, QC, Canada. Electronic address: [email protected].; Department of Woman-Mother-Child, Clinic of Neonatology, University Hospital Center and University of Lausanne, Lausanne, Switzerland. Electronic address: [email protected].; Department of Paediatrics, The George Washington University. Division of Neonatology, Children's National Hospital, Washington, DC, USA. Electronic address: [email protected].; Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and the University of Toronto, Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada. Electronic address: [email protected].; Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK. Electronic address: [email protected].

DOI: 10.1016/j.siny.2021.101268

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MeSH Terms: Blood Glucose, Brain Injuries, Humans, Hypothermia, Hypothermia, Induced, Hypoxia-Ischemia, Brain, Infant, Newborn