Elisabeth S Yan1, Valerie Y Chock1, Sonia Lomeli Bonifacio1, Alex Dahlen2, Carolina V Guimaraes3, Gabriel Altit4, Shazia Bhombal1, Krisa Van Meurs5. 1. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, CA, USA. 2. Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, USA. 3. Pediatric Radiology Division, University of North Carolina Children's Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 4. Department of Pediatrics, Division of Neonatology, Montreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada. 5. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, CA, USA. vanmeurs@stanford.edu.
Abstract
OBJECTIVE: To evaluate multi-organ dysfunction (MOD) in newborns treated with therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE), and to compare MOD in those with normal/mild magnetic resonance imaging (MRI) findings to those with moderate to severe MRI findings or death. STUDY DESIGN: Retrospective single-center observational study of infants treated with TH. A total of 16 parameters across 7 organ systems were analyzed. Primary outcome was death or moderate to severe brain injury on MRI. RESULT: Of 157 infants treated with TH, 77% had ≥2 organ systems with dysfunction. The number of organ systems with dysfunction was strongly associated with death or moderate-to-severe brain injury (p < 0.0001). Hematologic (68%) and hepatic (65%) dysfunction were most common. Neurologic and renal dysfunction were most strongly associated with the primary outcome (OR 13.5 [6.1-29.8] and 11.2 [4.1-30.3], respectively), while pulmonary hypertension was not. CONCLUSION: MOD is prevalent in infants undergoing TH for HIE, and the association between MOD and adverse outcomes may impact clinical care and counseling.
OBJECTIVE: To evaluate multi-organ dysfunction (MOD) in newborns treated with therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE), and to compare MOD in those with normal/mild magnetic resonance imaging (MRI) findings to those with moderate to severe MRI findings or death. STUDY DESIGN: Retrospective single-center observational study of infants treated with TH. A total of 16 parameters across 7 organ systems were analyzed. Primary outcome was death or moderate to severe brain injury on MRI. RESULT: Of 157 infants treated with TH, 77% had ≥2 organ systems with dysfunction. The number of organ systems with dysfunction was strongly associated with death or moderate-to-severe brain injury (p < 0.0001). Hematologic (68%) and hepatic (65%) dysfunction were most common. Neurologic and renal dysfunction were most strongly associated with the primary outcome (OR 13.5 [6.1-29.8] and 11.2 [4.1-30.3], respectively), while pulmonary hypertension was not. CONCLUSION: MOD is prevalent in infants undergoing TH for HIE, and the association between MOD and adverse outcomes may impact clinical care and counseling.
Authors: Jeffrey M Perlman; Jonathan Wyllie; John Kattwinkel; Dianne L Atkins; Leon Chameides; Jay P Goldsmith; Ruth Guinsburg; Mary Fran Hazinski; Colin Morley; Sam Richmond; Wendy M Simon; Nalini Singhal; Edgardo Szyld; Masanori Tamura; Sithembiso Velaphi Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
Authors: A J Barkovich; B L Hajnal; D Vigneron; A Sola; J C Partridge; F Allen; D M Ferriero Journal: AJNR Am J Neuroradiol Date: 1998-01 Impact factor: 3.825