Hyperglycaemia in infants with hypoxic-ischaemic encephalopathy is associated with improved outcomes after therapeutic hypothermia: a post hoc analysis of the CoolCap Study
Hyperglycaemia in infants with hypoxic-ischaemic encephalopathy is associated with improved outcomes after therapeutic hypothermia: a post hoc analysis of the CoolCap Study
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DOI：
10.1136/archdischild-2016-311385
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发表时间：
2017-07-01
影响因子：
4.4
通讯作者：
Kaiser, Jeffrey R.
中科院分区：
文献类型：
--
作者：
Basu, Sudeepta K.;Salemi, Jason L.;Kaiser, Jeffrey R.
目的探讨围生期缺氧缺血性脑病（HIE）患儿的多器官功能障碍及对低温的反应是否与贫血有关。194/234例（83%）妊娠≥ 36周的婴儿，在CoolCap研究中登记了1例重度HIE，记录了血浆葡萄糖水平和随访结果。干预婴儿被随机分配到出生后6小时内开始的头部冷却或标准护理，持续72小时。在随机化后的预定时间间隔测量血糖水平。主要结果测量不利的主要结果定义为18个月时的死亡和/或严重的神经发育障碍。随机分组后12小时内的血糖谱（低血糖（8.3 mmol/L）和正常血糖）与多器官功能障碍或低温治疗后主要结局风险降低的相关性进行了研究。结果低血糖而非高血糖与更紊乱的多器官功能参数相关（平均pH 7.23（SD 0.16）vs 7.36（0.13），p
Objective To investigate whether glycaemic profile is associated with multiorgan dysfunction and with response to hypothermia after perinatal hypoxic ischaemic encephalopathy (HIE).Design Post hoc analysis of the CoolCap Study.Setting 25 perinatal centres in UK, USA and New Zealand during 1999-2002.Patients 194/234 (83%) infants of >= 36 weeks' gestation with moderate-to-severe HIE enrolled in the CoolCap Study with documented plasma glucose levels and follow-up outcome.Intervention Infants were randomised to head cooling for 72 hours starting within 6 hours of birth or standard care. Plasma glucose levels were measured at predetermined time intervals after randomisation.Main outcome measure Unfavourable primary outcome was defined as death and/or severe neurodevelopmental disability at 18 months. Glycaemic profile (hypoglycaemia (8.3 mmol/L) and normoglycaemia) during 12 hours after randomisation was investigated for association with multiorgan dysfunction or risk reduction of primary outcome after hypothermia treatment.Results Hypoglycaemia but not hyperglycaemia was associated with more deranged multiorgan function parameters (mean pH 7.23 (SD 0.16) vs 7.36 (0.13), p