John Flibotte1,2, Abbot R Laptook3, Seetha Shankaran4, Scott A McDonald5, Mariana C Baserga6, Edward F Bell7, C Michael Cotten8, Abhik Das9, Sara B DeMauro1,2, Tara L DuPont6, Eric C Eichenwald1,2, Roy Heyne10, Erik A Jensen1,2, Krisa P Van Meurs11, Kevin Dysart12. 1. Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 2. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 3. Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA. 4. Department of Pediatrics, Wayne State University, Detroit, MI, USA. 5. Biostatistics and Epidemiology, RTI International, Research Triangle Park, NC, USA. 6. Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. 7. Department of Pediatrics, University of Iowa, Iowa City, IA, USA. 8. Department of Pediatrics, Duke University, Durham, NC, USA. 9. Biostatistics and Epidemiology, RTI International, Rockville, MD, USA. 10. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA. 11. Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA. 12. Division of Neonatal and Perinatal Medicine, Alfred I. duPont Hospital for Children, Wilmington, DE, USA. Kevin.Dysart@nemours.org.
Abstract
OBJECTIVE: Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE). STUDY DESIGN: Retrospective cohort study of 181 infants with HIE who received TH in two randomized trials within the Neonatal Research Network. We defined summative blanket temperature constructs and evaluated for association with a primary composite outcome of death or moderate/ severe disability at 18-22 months. RESULTS: Each 0.5 °C above 33.5 °C in the mean of the highest quartile blanket temperature was associated with a 52% increase in the adjusted odds of death/ disability (aOR 1.52, 95% CI 1.09-2.11). Having >8 consecutive blanket temperatures above 33.5 °C rendered an aOR of death/disability of 5.04 in the first 24 h (95% CI 1.54-16.6) and 6.92 in the first 48 h (95% CI 2.20-21.8) of TH. CONCLUSIONS: Higher blanket temperature during TH may be an early, clinically useful biomarker of HIE outcome.
OBJECTIVE: Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE). STUDY DESIGN: Retrospective cohort study of 181 infants with HIE who received TH in two randomized trials within the Neonatal Research Network. We defined summative blanket temperature constructs and evaluated for association with a primary composite outcome of death or moderate/ severe disability at 18-22 months. RESULTS: Each 0.5 °C above 33.5 °C in the mean of the highest quartile blanket temperature was associated with a 52% increase in the adjusted odds of death/ disability (aOR 1.52, 95% CI 1.09-2.11). Having >8 consecutive blanket temperatures above 33.5 °C rendered an aOR of death/disability of 5.04 in the first 24 h (95% CI 1.54-16.6) and 6.92 in the first 48 h (95% CI 2.20-21.8) of TH. CONCLUSIONS: Higher blanket temperature during TH may be an early, clinically useful biomarker of HIE outcome.
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