BACKGROUND AND AIM: The benefits of therapeutic hypothermia have not been assessed from the perspective of the neurology clinic. We aimed to report the impact of the implementation of a local regional therapeutic hypothermia program on the neurodevelopmental outcomes of surviving hypoxic-ischemic encephalopathy (HIE) infants who were followed in the neonatal neurology clinic. METHODS: Retrospective analysis of term infants referred to the neonatal neurology clinic after having been diagnosed with HIE and meeting eligibility criteria for therapeutic hypothermia between March 1999 and June 2010. Therapeutic hypothermia was implemented in September 2008. Outcome measures were dichotomously defined as: normal or adverse, which included cerebral palsy, global developmental delay, and epilepsy. RESULTS: Thirty infants were included in the pre-therapeutic hypothermia group. Thirty-one infants received therapeutic hypothermia and 27 were adequately followed and included in the post-therapeutic hypothermia group. The frequency of an adverse outcome was significantly higher in the pre-therapeutic hypothermia infants (19/30 [63%] versus 4/27 [15%]; OR = 0.10; 95% CI, 0.03-0.37; P < 0.001). Neonatal clinical seizures were more frequent in the pre-therapeutic hypothermia group (P = 0.012). There were no differences regarding frequency of fetal distress, rate of caesarean sections, Apgar scores, need of resuscitation, cord/initial blood gases, and degrees of encephalopathy between the two groups. CONCLUSIONS: The implementation of a regional therapeutic hypothermia program in our institution has vastly reduced the observed neurological morbidity of surviving HIE infants followed in our neonatal neurology clinic. A similar change in outcomes of infants with HIE can be anticipated by other centers and other clinics adopting this therapy.
BACKGROUND AND AIM: The benefits of therapeutic hypothermia have not been assessed from the perspective of the neurology clinic. We aimed to report the impact of the implementation of a local regional therapeutic hypothermia program on the neurodevelopmental outcomes of surviving hypoxic-ischemicencephalopathy (HIE) infants who were followed in the neonatal neurology clinic. METHODS: Retrospective analysis of term infants referred to the neonatal neurology clinic after having been diagnosed with HIE and meeting eligibility criteria for therapeutic hypothermia between March 1999 and June 2010. Therapeutic hypothermia was implemented in September 2008. Outcome measures were dichotomously defined as: normal or adverse, which included cerebral palsy, global developmental delay, and epilepsy. RESULTS: Thirty infants were included in the pre-therapeutic hypothermia group. Thirty-one infants received therapeutic hypothermia and 27 were adequately followed and included in the post-therapeutic hypothermia group. The frequency of an adverse outcome was significantly higher in the pre-therapeutic hypothermiainfants (19/30 [63%] versus 4/27 [15%]; OR = 0.10; 95% CI, 0.03-0.37; P < 0.001). Neonatal clinical seizures were more frequent in the pre-therapeutic hypothermia group (P = 0.012). There were no differences regarding frequency of fetal distress, rate of caesarean sections, Apgar scores, need of resuscitation, cord/initial blood gases, and degrees of encephalopathy between the two groups. CONCLUSIONS: The implementation of a regional therapeutic hypothermia program in our institution has vastly reduced the observed neurological morbidity of surviving HIEinfants followed in our neonatal neurology clinic. A similar change in outcomes of infants with HIE can be anticipated by other centers and other clinics adopting this therapy.
Authors: Houchun H Hu; Tai-Wei Wu; Larry Yin; Mimi S Kim; Jonathan M Chia; Thomas G Perkins; Vicente Gilsanz Journal: Magn Reson Imaging Date: 2013-10-15 Impact factor: 2.546
Authors: Martha V Douglas-Escobar; Shelley C Heaton; Jeffrey Bennett; Linda J Young; Olena Glushakova; Xiaohui Xu; Daphna Yasova Barbeau; Candice Rossignol; Cindy Miller; Alissa M Old Crow; Ronald L Hayes; Michael D Weiss Journal: Front Neurol Date: 2014-12-19 Impact factor: 4.003
Authors: Martha Douglas-Escobar; Monique Mendes; Candace Rossignol; Nikolay Bliznyuk; Ariana Faraji; Abdullah S Ahmad; Sylvain Doré; Michael D Weiss Journal: Front Pediatr Date: 2018-05-01 Impact factor: 3.418
Authors: Aisling A Garvey; Andreea M Pavel; John M O'Toole; Brian H Walsh; Irina Korotchikova; Vicki Livingstone; Eugene M Dempsey; Deirdre M Murray; Geraldine B Boylan Journal: Pediatr Res Date: 2021-04-20 Impact factor: 3.756