Short-term outcomes after perinatal hypoxic ischemic encephalopathy: a report from the Children’s Hospitals Neonatal Consortium HIE focus group

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Short-term outcomes after perinatal hypoxic ischemic encephalopathy: a report from the Children’s Hospitals Neonatal Consortium HIE focus group


نویسنده	Massaro A N ,Murthy K ,Zaniletti I ,Cook N ,DiGeronimo R ,Dizon M ,Hamrick S E G ,McKay V J ,Natarajan G ,Rao R ,Smith D ,Telesco R ,Wadhawan R ,Asselin J M ,Durand D J ,Evans J R ,Dykes F ,Reber K M ,Padula M A ,Pallotto E K ,Short B L ,Mathur A M
منبع	journal of perinatology - 2015 - دوره : 35 - شماره : 4 - صفحه:290 -296
چکیده	Objective:to characterize infants affected with perinatal hypoxic ischemic encephalopathy (hie) who were referred to regional neonatal intensive care units (nicus) and their related short-term outcomes.study design:this is a descriptive study evaluating the data collected prospectively in the children’s hospital neonatal database, comprised of 27 regional nicus within their associated children’s hospitals. a consecutive sample of 945 referred infants born ⩾36 weeks’ gestation with perinatal hie in the first 3 days of life over approximately 3 years (2010–july 2013) were included. maternal and infant characteristics are described. short-term outcomes were evaluated including medical comorbidities, mortality and status of survivors at discharge.result:high relative frequencies of maternal predisposing conditions, cesarean and operative vaginal deliveries were observed. low apgar scores, profound metabolic acidosis, extensive resuscitation in the delivery room, clinical and electroencephalographic (eeg) seizures, abnormal eeg background and brain imaging directly correlated with the severity of hie. therapeutic hypothermia was provided to 85% of infants, 15% of whom were classified as having mild hie. electrographic seizures were observed in 26% of the infants. rates of complications and morbidities were similar to those reported in prior clinical trials and overall mortality was 15%.conclusion:within this large contemporary cohort of newborns with perinatal hie, the application of therapeutic hypothermia and associated neurodiagnostic studies appear to have expanded relative to reported clinical trials. although seizure incidence and mortality were lower compared with those reported in the trials, it is unclear whether this represented improved outcomes or therapeutic drift with the treatment of milder disease.

آدرس	George Washington University School of Medicine, Department of Pediatrics, USA, Northwestern University Chicago, Department of Pediatrics, USA, Children’s Hospitals Association, USA, Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, USA, University of Utah and the Primary Children's Medical Center, Department of Pediatrics, USA, Northwestern University Chicago, Department of Pediatrics, USA, Emory University Department of Pediatrics and Children's Healthcare of Atlanta at Egleston, USA, All Children’s Hospital, USA, Wayne State University, Department of Pediatrics, USA, Washington University School of Medicine and St Louis Children’s Hospital, Department of Pediatrics, USA, University of Colorado, Department of Pediatrics, USA, Children’s Hospital of Pittsburgh of UPMC, USA, Florida Hospital for Children, USA, Children’s Hospital Oakland & Research Center, USA, Children’s Hospital Oakland & Research Center, USA, Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, USA, Emory University Department of Pediatrics and Children's Healthcare of Atlanta at Egleston, USA, The Ohio State University School of Medicine, USA, Perelman School of Medicine at the University of Pennsylvania, Department of Pediatrics, USA, University of Missouri School of Medicine, USA, George Washington University School of Medicine, Department of Pediatrics, USA, University of Colorado, Department of Pediatrics, USA



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