Ipsita R Goswami1, Hilary Whyte1, Pia Wintermark2, Khorshid Mohammad3, Sandesh Shivananda4, Deepak Louis5, Eugene W Yoon6, Prakesh S Shah7,8. 1. Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada. 2. Department of Pediatrics, McGill University, Montreal, QC, Canada. 3. Department of Pediatrics, University of Calgary, Calgary, AB, Canada. 4. Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada. 5. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada. 6. Maternal-infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada. 7. Maternal-infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada. Prakeshkumar.Shah@sinaihealthsystem.ca. 8. Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada. Prakeshkumar.Shah@sinaihealthsystem.ca.
Abstract
OBJECTIVE: To compare the characteristics and outcomes of neonates with mild hypoxic-ischemic encephalopathy (HIE) who received hypothermia versus standard care. STUDY DESIGN: We conducted a retrospective cohort study of neonates ≥35 weeks' gestation and ≥1800 g admitted with a diagnosis of Sarnat stage 1 encephalopathy. We evaluated length of hospital stay, duration of ventilation, evidence of brain injury on MRI, and neonatal morbidities. RESULTS: Of 1089 eligible neonates, 393 (36%) received hypothermia and 595 (55%) had neuroimaging. The hypothermia group was more likely to be outborn, born via C-section, had lower Apgar scores, and required extensive resuscitation. They had longer durations of stay (9 vs. 6 days, P < 0.001), respiratory support (3 vs. 2 days, P < 0.001), but lower odds of brain injury on MRI (adjusted odds ratio 0.33, 95% CI: 0.22-0.52) compared with standard care group. CONCLUSION: Despite prolongation of hospital stay, hypothermia may be potentially beneficial in neonates with mild HIE; however, selection bias cannot be ruled out.
OBJECTIVE: To compare the characteristics and outcomes of neonates with mild hypoxic-ischemicencephalopathy (HIE) who received hypothermia versus standard care. STUDY DESIGN: We conducted a retrospective cohort study of neonates ≥35 weeks' gestation and ≥1800 g admitted with a diagnosis of Sarnat stage 1 encephalopathy. We evaluated length of hospital stay, duration of ventilation, evidence of brain injury on MRI, and neonatal morbidities. RESULTS: Of 1089 eligible neonates, 393 (36%) received hypothermia and 595 (55%) had neuroimaging. The hypothermia group was more likely to be outborn, born via C-section, had lower Apgar scores, and required extensive resuscitation. They had longer durations of stay (9 vs. 6 days, P < 0.001), respiratory support (3 vs. 2 days, P < 0.001), but lower odds of brain injury on MRI (adjusted odds ratio 0.33, 95% CI: 0.22-0.52) compared with standard care group. CONCLUSION: Despite prolongation of hospital stay, hypothermia may be potentially beneficial in neonates with mild HIE; however, selection bias cannot be ruled out.
Authors: Sujith Kumar Reddy Gurram Venkata; Prakesh S Shah; Marc Beltempo; Eugene Yoon; Stephen Wood; Matthew Hicks; Thierry Daboval; Jonathan Wong; Pia Wintermark; Khorshid Mohammad Journal: Childs Nerv Syst Date: 2022-06-08 Impact factor: 1.532