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Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy
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  • Published on:
    Response to Prof. Shah's Letter

    Dear Editor,

    Professor Shah has submitted a comprehensive and well-documented response that agrees and disagrees with my letters. With clarification of a few points, I find that we may be very close to complete agreement, and to major improvement in neonatal outcome.

    Regarding the definition of “asphyxia,” for want of a better, I use the term to describe the sum total of pathologies produced by compressi...

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    Conflict of Interest:
    None declared.
  • Published on:
    Reply to Morley
    • Prakesh S Shah, Staff Neonatologist and Assistant professor
    • Other Contributors:
      • Max Perlman

    Dear Editor,

    We are glad to respond to the comments of Dr. George Morley [1] on our paper entitled “Multiorgan Dysfunction in Infants with Post- asphyxial Hypoxic Ischaemic Encephalopathy”.[2] Dr. Morley raised the possibility that the cause of the HIE in our patients was hypovolaemia due to deprivation of the placental transfusion (with or without tight nuchal cord) rather than intrapartum asphyxia. We will att...

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    Conflict of Interest:
    None declared.
  • Published on:
    Reply to Tarcan et al.

    Dear Editor

    We read with interest the letter by Tarcan et al. [1] in response to our article.[2] Tarcan et al. [1] discussed specifically the criteria for the hepatic involvement in post-asphyxial hypoxic ischemic encephalopathy (PA-HIE) infants. We agree with Tarcan et al.[1] that ALT is a better marker of liver injury than AST for the reasons given in their letter.

    To compare ou...

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    Conflict of Interest:
    None declared.
  • Published on:
    Retraction Respiration: the Multiorgan Dysfunction that Causes Ischemic Encephalopathy

    Dear Editor

    Retraction respiration (RR) is a pulmonary dysfunction frequently seen in neonates that develop hypoxic-ischemic encephalopathy. (HIE) It consists of short, strong inspiratory efforts using accessory muscles such as the sterno-mastoid to elevate and expand the rib cage that result in retraction of the sub-costal abdominal wall and intercostal skin. Clinically it is gasping respiration.

    RR i...

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    Conflict of Interest:
    None declared.
  • Published on:
    Hypovolemia:The Cause of Multiorgan Dysfunction

    Dear Editor

    The authors’ premise that neonatal multiorgan dysfunction (MOD) in HIE is caused primarily by asphyxia that reflexively shunts circulation from all body parts to the heart and brain is not very plausible. The diving reflex does not last very long. If anoxia persists, the heart and brain soon exhaust oxyhemoglobin, cardiac arrest and death (tissue necrosis) follow rapidly. If oxygenation is restor...

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    Conflict of Interest:
    None declared.
  • Published on:
    Questioning the Criteria for Hepatic Involvement In Hypoxic-Ischemic Encephalopathy
    • Aylin Tarcan, Neonatologist
    • Other Contributors:
      • Berkan Grakan, Filiz Tiker

    Dear Editor

    We read with interest the article by Shah et al. in which the authors compared groups of neonates with good versus poor outcomes after severe perinatal asphyxia (PNA).[1]

    Shah et al. reported marginal differences in the incidences of kidney and cardiovascular system dysfunction, but found no differences with respect to pulmonary or hepatic dysfunction. This article raises an import...

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    Conflict of Interest:
    None declared.