Intraventricular hemorrhage in term neonates with hypoxic-ischemic encephalopathy: a comparison study between neonates treated with and without hypothermia
Intraventricular hemorrhage in term neonates with hypoxic-ischemic encephalopathy: a comparison study between neonates treated with and without hypothermia
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DOI：
10.21037/qims.2016.08.07
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发表时间：
2016-10-01
影响因子：
2.8
通讯作者：
Epelman, Monica
中科院分区：
文献类型：
--
作者：
Gorelik, Natalia;Faingold, Ricardo;Epelman, Monica
背景资料：回顾性地确定脑室内出血（IVH）的患病率在足月新生儿缺氧缺血性脑病（HIE）使用头部超声（HUS）和MRI，并比较IVH的发病率在足月新生儿缺氧缺血性脑病治疗的治疗性低温与那些管理contradition.Methods：共61个足月新生儿从两个机构出生后不久被诊断为缺氧缺血性脑病。来自一个机构的30名婴儿接受了全身低温治疗。这些婴儿必须符合该机构新生儿体温过低方案的入学标准。31名新生儿在第二家机构接受常规治疗。当时，低温还不是该机构的护理标准。所有新生儿在出生后23天内均接受了HUS。54名幸存者也接受了MRI检查。结果：在接受全身低温的30名婴儿中，有18名男性和12名女性，平均出生体重为3.5 kg（2.5至5.2 kg），HUS研究在出生后14.8至41小时内进行。常规治疗的31名婴儿组包括12名男孩和19名女孩，婴儿平均出生体重为3.3 kg（2.3至4.2 kg），他们在出生后1至23天接受HUS，只有5名儿童在成像研究时超过1周。61名婴儿中有4名（7%）在HUS上被诊断为IVH。3例经MRI证实。第四例显示双侧脉络丛扩大的HUS，但IVH不能证实与MRI，因为婴儿没有生存。在低温治疗的新生儿组中，有3例（10%）IVH，而在常规管理的组中，IVH发生在一个婴儿（3%.Conclusions）：我们的研究表明，IVH仍然不常见的足月新生儿HIE。IVH在低温治疗组中更普遍。
Background: To retrospectively determine the prevalence of intraventricular hemorrhage (IVH) in term neonates with hypoxic-ischemic encephalopathy (HIE) using head ultrasound (HUS) and MRI, and to compare the incidence of IVH in term babies with HIE treated by therapeutic hypothermia versus those managed conventionally.Methods: A total of 61 term neonates from two institutions were diagnosed with HIE shortly after birth. Thirty infants from one institution were treated with whole body hypothermia. These infants had to satisfy the entry criteria for the neonatal hypothermia protocol of the institution. Thirty-one neonates underwent conventional treatment at the second institution. At that time, hypothermia was not yet a standard of care at that institution. All the neonates underwent HUS in their first 23 days of life. The 54 survivors also underwent MRI. The imaging studies were all reviewed for IVH.Results: Amongst the 30 babies, who received whole body hypothermia, there were 18 males and 12 females, the mean birth weight was 3.5 kg (2.5 to 5.2 kg), and the HUS study was performed within 14.8 to 41 hours of life. The group of 31 infants treated conventionally was comprised of 12 boys and 19 girls, the infants had an average birth weight of 3.3 kg (2.3 to 4.2 kg), and they underwent HUS 1 to 23 days after birth, with only five children being older than 1 week at the time of the imaging studies. Four of the 61 infants (7%) were diagnosed with IVH on HUS. Three were confirmed with MRI. The fourth case showed a bilateral enlarged choroid plexus on HUS, but IVH could not be confirmed with MRI, as the infant did not survive. In the group of neonates treated with hypothermia, there were three cases (10%) of IVH, whereas in the group managed conventionally, IVH occurred in one infant (3%).Conclusions: Our study shows that IVH remains uncommon in term infants with HIE. IVH was more prevalent in the group treated with hypothermia.