Clinical characteristics and short-term outcomes of neonates with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia: A single-center experience from Serbia

Author:

Međo BiljanaORCID,Karličić MarijaORCID,Jovandarić MiljanaORCID,Atanasković-Marković MarinaORCID,Raus MiselaORCID,Nikolić DimitrijeORCID,Nikolić DejanORCID

Abstract

Aim: This study aimed to report clinical characteristics and short-term outcomes of neonates with hypoxic-ischemic encephalopathy (HIE) treated with hypothermia. Furthermore, we analyzed the factors associated with short-term outcomes. Material and Methods: We conducted a single-center retrospective study including neonates with HIE treated with hypothermia who survived hospital discharge. The short-term outcomes included normal or abnormal neurological examination findings on discharge. Results: Forty-five neonates with HIE treated with hypothermia were identified. Median Apgar score at 1 minute was 3 (range 0-7), at 5 minutes it was 5 (range 1-10), while the median blood pH in the first postnatal hour was 6.94 (range 6.8-7.2). On admission, there were more neonates with moderate encephalopathy than those with severe encephalopathy according to the modified Sarnat classification (77.8% vs. 22.2%, p<0.001). Twelve (26.7%) neonates presented with complications during hypothermia. The most common complications were coagulopathy presented in 33.3% of cases and arterial hypotension presented in 25% of cases. Twenty-nine (64.44%) neonates had normal neurological examination, whereas 16 (35.56%) presented with abnormal neurological examination findings at discharge (0.006). Twenty-four (53.3%) neonates were discharged from hospital without any therapy. According to univariate analysis, abnormal neurological examination findings on discharge were significantly associated with pH < 7 (p=0.009), 5-minute Apgar score ≤ 5 (p=0.010), and the presence of complications during hypothermia (p=0.013). According to multivariate analysis, abnormal neurological examination findings on discharge were significantly associated with pH < 7 (p=0.030) and the presence of complications (p=0.035). Conclusion: Our results during the first five years of experience with hypothermia support the beneficial effect of hypothermia in neonates with HIE.

Publisher

Centre for Evaluation in Education and Science (CEON/CEES)

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