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Safety and Short-Term Outcomes of Therapeutic Hypothermia in Preterm Neonates 34-35 Weeks Gestational Age with Hypoxic-Ischemic Encephalopathy.
Rao, Rakesh; Trivedi, Shamik; Vesoulis, Zachary; Liao, Steve M; Smyser, Christopher D; Mathur, Amit M.
Afiliação
  • Rao R; Division of Newborn-Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO. Electronic address: Rao_R@kids.wustl.edu.
  • Trivedi S; Division of Newborn-Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO.
  • Vesoulis Z; Division of Newborn-Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO.
  • Liao SM; Division of Newborn-Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO.
  • Smyser CD; Division of Pediatric Neurology, Departments of Neurology, Pediatrics, and Radiology, Washington University School of Medicine, St Louis, MO.
  • Mathur AM; Division of Newborn-Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO.
J Pediatr ; 183: 37-42, 2017 04.
Article em En | MEDLINE | ID: mdl-27979578
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Recém-Nascido Prematuro / Hipóxia-Isquemia Encefálica / Hipotermia Induzida Tipo de estudo: Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Recém-Nascido Prematuro / Hipóxia-Isquemia Encefálica / Hipotermia Induzida Tipo de estudo: Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos