Abstract
Background: To evaluate the safety and neurological outcomes of therapeutic hypothermia to neonatal hypoxic-ischemic encephalopathy (HIE).Materials and Methods: Medical records of 61 neonates with moderate to severe HIE were retrospectively enrolled and divided into a therapeutic hypothermia group (n = 36) and conventional therapy group (n = 25).Results: No significant difference in the incidence of severe adverse events was found between the two groups. Minimum and maximum voltages of amplitude-integrated electroencephalography (aEEG) recording results showed statistically significant differences in therapeutic hypothermia group after 72 h. The neonatal behavioral neurological assessment (NBNA) on the 28th day after birth and Bayley Scales of Infant Development, second edition (BSID II) scores at 18 months old were significant higher in the therapeutic hypothermia group than the conventional therapy group.Conclusion: Therapeutic hypothermia for neonates with moderate to severe HIE improved the development of the nervous system in 0–18-month-old infants and showed a predominant role in reducing death and major neuron development-associated disabilities.
Highlights
Neonatal hypoxic-ischemic encephalopathy (HIE), mainly caused by perinatal asphyxia, commonly leads to brain damage which manifests as growth disorders, neuro-disability, and even death (Millar et al, 2017)
A total of 61 newborns diagnosed with moderate to severe HIE were enrolled from January 2010 to December 2016 in the neonatal intensive care unit (NICU) of Shanghai Children’s Hospital, including 36 cases in the therapeutic hypothermia group and 25 cases in the conventional therapy group
The neonatal behavioral neurological assessment (NBNA) score of infants who were treated with therapeutic hypothermia was significantly increased compared with the infants in the conventional therapy group (39.1 ± 1.6 vs. 34.2 ± 2.1)
Summary
Neonatal hypoxic-ischemic encephalopathy (HIE), mainly caused by perinatal asphyxia, commonly leads to brain damage which manifests as growth disorders, neuro-disability, and even death (Millar et al, 2017). During the treatment of therapeutic hypothermia to neonates with HIE, amplitudeintegrated electroencephalography (aEEG) has been used to monitor and evaluate cerebral activity (Thoresen et al, 2010; Skranes et al, 2017). Quite a few studies have investigated the association between aEEG patterns after therapeutic hypothermia and evaluation of neurodevelopment outcome such as Bayley Scales of Infant Development, second edition (BSID II). We report the results of therapeutic hypothermia for moderate to severe HIE, and followup neurodevelopmental outcomes at the 28th day after birth and at 18 months old to evaluate its safety and efficacy. We aim to determine the effect of therapeutic hypothermia on neurological outcomes and the prognostic prediction value of aEEG in infants who survive HIE. To evaluate the safety and neurological outcomes of therapeutic hypothermia to neonatal hypoxic-ischemic encephalopathy (HIE)
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