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Therapeutic hypothermia for neonatal hypoxic‐ischaemic encephalopathy had favourable outcomes at a referral hospital in a middle‐income country
Author(s) -
Kali Gugulabatembunamahlubi Tenjiwe Jabulile,
MartinezBiarge Miriam,
Van Zyl Jeanetta,
Smith Johan,
Rutherford Mary
Publication year - 2016
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13392
Subject(s) - medicine , hypothermia , referral , encephalopathy , neonatal encephalopathy , tertiary referral centre , emergency medicine , hypoxic ischemic encephalopathy , intensive care medicine , pediatrics , anesthesia , family medicine
Aim This South African study documented the survival and neurodevelopmental outcomes of infants with hypoxic‐ischaemic encephalopathy ( HIE ) after introducing cooling to a neonatal intensive care unit and identified early markers for neurodevelopmental outcome. Methods We retrospectively reviewed infants that received cooling according to the Total Body Hypothermia trial protocol from 2008 to 2011. Infants were screened with the Bayley Scales of Infant and Toddler Development, Third Edition, at one year of age and underwent neurological and hearing assessments. Results Data on 99 infants with HIE showed that 45% of cases were moderate, 23% severe and 32% mild. An abnormal amplitude integrated electro‐encephalogram (a EEG ) background was documented in 45 cases within 24 hours. Magnetic resonance imaging ( MRI ) scans were consistent with HIE in all but one case. We reviewed 50 traceable survivors at one year. Development was significantly impaired in nine and 41 were normal or mildly impaired. A severely abnormal a EEG background, severe HIE and an abnormal MRI were associated with death and severe impairment. A good suck, mild HIE , primiparity and normal MRI were associated with good outcomes. Conclusion Most infants with HIE survived without major impairment. Previously described predictors of neurodevelopmental outcome were good surrogate markers in this population.