Safety and Short-Term Outcomes of Therapeutic Hypothermia in Preterm Neonates 34-35 Weeks Gestational Age with Hypoxic-Ischemic Encephalopathy - 18/04/17
, Shamik Trivedi, MD 1, Zachary Vesoulis, MD 1, Steve M. Liao, MD 1, Christopher D. Smyser, MD 2, Amit M. Mathur, MD 1Abstract |
Objective |
To evaluate the safety and short-term outcomes of preterm neonates born at 34-35 weeks gestation with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia.
Study design |
Medical records of preterm neonates born at 34-35 weeks gestational age with HIE treated with therapeutic hypothermia were retrospectively reviewed. Short-term safety outcomes and the presence, severity (mild, moderate, severe), and patterns of brain injury on magnetic resonance imaging were reviewed using a standard scoring system, and compared with a cohort of term neonates with HIE treated with therapeutic hypothermia.
Results |
Thirty-one preterm and 32 term neonates were identified. Therapeutic hypothermia-associated complications were seen in 90% of preterm infants and 81.3% of term infants (P = .30). In the preterm infants, hyperglycemia (58.1% vs31.3%, P = .03) and rewarming before completion of therapeutic hypothermia (19.4% vs 0.0%, P = .009) were more likely compared with term infants. All deaths occurred in the preterm group (12.9% vs 0%, P = .04). Neuroimaging showed the presence of injury in 80.6% of preterm infants and 59.4% of term infants (P = .07), with no differences in injury severity. Injury to the white matter was more prevalent in preterm infants compared with term infants (66.7% vs 25.0%, P = .001).
Conclusions |
Therapeutic hypothermia in infants born at 34-35 weeks gestational age appears feasible. Risks of mortality and side effects warrant caution with use of therapeutic hypothermia in preterm infants.
Le texte complet de cet article est disponible en PDF.Keywords : white matter injury, safety, magnetic resonance imaging, hypoxic-ischemic encephalopathy, therapeutic hypothermia
Abbreviations : DNGM, EEG, HIE, MRI, PLIC, WM
Plan
| Funded by the Thrasher Foundation (to A.M.). The authors declare no conflicts of interest. |
Vol 183
P. 37-42 - avril 2017 Retour au numéro
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