Agnes Jermendy1, Patrick J McNamara2,3,4, Kata Kovacs1, Regan E Giesinger5,6, Andrea Lakatos7,8, Attila J Szabo1,9, Miklos Szabo1. 1. Division of Neonatology 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary. 2. Department of Pediatrics, University of Iowa, Iowa city, IA, USA. patrick-mcnamara@uiowa.edu. 3. Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada. patrick-mcnamara@uiowa.edu. 4. Department of Internal Medicine, University of Iowa, Iowa city, IA, USA. patrick-mcnamara@uiowa.edu. 5. Department of Pediatrics, University of Iowa, Iowa city, IA, USA. 6. Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada. 7. Department of Neuroradiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary. 8. Faculty of Health Sciences, University of Miskolc, Miskolc, Hungary. 9. MTA-SE Pediatric and Nephrology Research Group, Budapest, Hungary.
Abstract
OBJECTIVE: To analyze the association between cardiovascular care and adverse outcome in infants undergoing therapeutic hypothermia for neonatal encephalopathy (NE). STUDY DESIGN: This was a retrospective cohort study of 176 infants with NE and hypotension, admitted to the SickKids Hospital (Center A, n = 86) or Semmelweis University (Center B, n = 90). RESULT: The lowest systolic/diastolic blood pressures were comparable amongst centers; however, proportion of cardiovascular support was lower in Center A (51% vs 97% in Center B). Overall rate of death or abnormal MRI (adverse outcome) were comparable between centers, although pattern differed with more basal ganglia injury in Center B. A 24-hour longer duration of cardiovascular support increased the odds for adverse outcome by 14%. CONCLUSION: We demonstrated that management of hemodynamic instability in infants with NE was markedly different in two high-volume NICUs and showed that longer duration of cardiovascular medication is an independent risk factor for adverse outcome.
OBJECTIVE: To analyze the association between cardiovascular care and adverse outcome in infants undergoing therapeutic hypothermia for neonatal encephalopathy (NE). STUDY DESIGN: This was a retrospective cohort study of 176 infants with NE and hypotension, admitted to the SickKids Hospital (Center A, n = 86) or Semmelweis University (Center B, n = 90). RESULT: The lowest systolic/diastolic blood pressures were comparable amongst centers; however, proportion of cardiovascular support was lower in Center A (51% vs 97% in Center B). Overall rate of death or abnormal MRI (adverse outcome) were comparable between centers, although pattern differed with more basal ganglia injury in Center B. A 24-hour longer duration of cardiovascular support increased the odds for adverse outcome by 14%. CONCLUSION: We demonstrated that management of hemodynamic instability in infants with NE was markedly different in two high-volume NICUs and showed that longer duration of cardiovascular medication is an independent risk factor for adverse outcome.
Authors: Regan E Giesinger; Amr I El Shahed; Michael P Castaldo; Colm R Breatnach; Vann Chau; Hilary E Whyte; Afif F El-Khuffash; Luc Mertens; Patrick J McNamara Journal: Am J Respir Crit Care Med Date: 2019-11-15 Impact factor: 21.405
Authors: C F W Baker; J D E Barks; C Engmann; D M Vazquez; C R Neal; R E Schumacher; V Bhatt-Mehta Journal: J Perinatol Date: 2008-03-13 Impact factor: 2.521
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