Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia
Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia
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DOI：
10.1038/s41372-019-0551-2
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发表时间：
2020-02-01
影响因子：
2.9
通讯作者：
Lee, Shoo K.
中科院分区：
文献类型：
--
作者：
Goswami, Ipsita R.;Whyte, Hilary;Lee, Shoo K.
目的 比较接受低温治疗与标准护理的轻度缺氧缺血性脑病 (HIE) 新生儿的特征和结局。研究设计 我们对妊娠 >= 35 周、体重 >= 1800 g、诊断为 Sarnat 1 期脑病的新生儿进行了一项回顾性队列研究。我们评估了住院时间、通气时间、MRI 上的脑损伤证据以及新生儿发病率。结果 在 1089 名符合条件的新生儿中，393 名（36%）接受了低温治疗，595 名（55%）接受了神经影像学检查。体温过低组更有可能是天生的、通过剖腹产出生的、阿普加评分较低、需要广泛的复苏。与标准护理组相比，他们的住院时间更长（9 天 vs. 6 天，P < 0.001），呼吸支持（3 vs. 2 天，P < 0.001），但 MRI 上脑损伤的几率较低（调整后比值比 0.33，95% CI：0.22-0.52）。结论 尽管住院时间延长，但低温治疗可能对轻度 HIE 新生儿有益；然而，不能排除选择偏差。
Objective To compare the characteristics and outcomes of neonates with mild hypoxic-ischemic encephalopathy (HIE) who received hypothermia versus standard care. Study design We conducted a retrospective cohort study of neonates >= 35 weeks' gestation and >= 1800 g admitted with a diagnosis of Sarnat stage 1 encephalopathy. We evaluated length of hospital stay, duration of ventilation, evidence of brain injury on MRI, and neonatal morbidities. Results Of 1089 eligible neonates, 393 (36%) received hypothermia and 595 (55%) had neuroimaging. The hypothermia group was more likely to be outborn, born via C-section, had lower Apgar scores, and required extensive resuscitation. They had longer durations of stay (9 vs. 6 days, P < 0.001), respiratory support (3 vs. 2 days, P < 0.001), but lower odds of brain injury on MRI (adjusted odds ratio 0.33, 95% CI: 0.22-0.52) compared with standard care group. Conclusion Despite prolongation of hospital stay, hypothermia may be potentially beneficial in neonates with mild HIE; however, selection bias cannot be ruled out.