BibTex format
@article{Montaldo:2019:10.1136/archdischild-2018-316040,
author = {Montaldo, P and Lally, P and Oliveira, V and Swamy, R and Mendoza, J and Atreja, G and Kariholu, U and Shivamurthappa, V and Liow, N and Teiserskas, J and Pryce, R and Soe, A and Shankaran, S and Thayyil, S},
doi = {10.1136/archdischild-2018-316040},
journal = {Archives of Disease in Childhood. Fetal and Neonatal Edition},
pages = {F515--F520},
title = {Therapeutic hypothermia initiated within 6 hours of birth is associated with reduced brain injury on MR biomarkers in mild hypoxic ischemic encephalopathy: a non-randomised cohort study},
url = {http://dx.doi.org/10.1136/archdischild-2018-316040},
volume = {104},
year = {2019}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Objective To examine the effect of therapeutic hypothermia on MR biomarkers and neurodevelopmental outcomes in babies with mild hypoxic-ischaemic encephalopathy (HIE).Design Non-randomised cohort study.Setting Eight tertiary neonatal units in the UK and the USA.Patients 47 babies with mild HIE on NICHD neurological examination performed within 6 hours after birth.Interventions Whole-body cooling for 72 hours (n=32) or usual care (n=15; of these 5 were cooled for <12 hours).Main outcome measures MRI and MR spectroscopy (MRS) within 2 weeks after birth, and a neurodevelopmental outcome assessment at 2 years.Results The baseline characteristics in both groups were similar except for lower 10 min Apgar scores (p=0.02) in the cooled babies. Despite this, the mean (SD) thalamic NAA/Cr (1.4 (0.1) vs 1.6 (0.2); p<0.001) and NAA/Cho (0.67 (0.08) vs 0.89 (0.11); p<0.001) ratios from MRS were significantly higher in the cooled group. Cooled babies had lower white matter injury scores than non-cooled babies (p=0.02). Four (27%) non-cooled babies with mild HIE developed seizures after 6 hours of age, while none of the cooled babies developed seizures (p=0.008). Neurodevelopmental outcomes at 2 years were available in 40 (85%) of the babies. Adverse outcomes were seen in 2 (14.3%) non-cooled babies, and none of the cooled babies (p=0.09).Conclusions Therapeutic hypothermia may have a neuroprotective effect in babies with mild HIE, as demonstrated by improved MRS biomarkers and reduced white matter injury on MRI. This may warrant further evaluation in adequately powered randomised controlled trials.
AU - Montaldo,P
AU - Lally,P
AU - Oliveira,V
AU - Swamy,R
AU - Mendoza,J
AU - Atreja,G
AU - Kariholu,U
AU - Shivamurthappa,V
AU - Liow,N
AU - Teiserskas,J
AU - Pryce,R
AU - Soe,A
AU - Shankaran,S
AU - Thayyil,S
DO - 10.1136/archdischild-2018-316040
EP - 520
PY - 2019///
SN - 1359-2998
SP - 515
TI - Therapeutic hypothermia initiated within 6 hours of birth is associated with reduced brain injury on MR biomarkers in mild hypoxic ischemic encephalopathy: a non-randomised cohort study
T2 - Archives of Disease in Childhood. Fetal and Neonatal Edition
UR - http://dx.doi.org/10.1136/archdischild-2018-316040
UR - http://hdl.handle.net/10044/1/65767
VL - 104
ER -
