Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia

on behalf of the Canadian Neonatal Network Investigators

doi:10.1038/s41372-019-0551-2

Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia

on behalf of the Canadian Neonatal Network Investigators

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

53 Citas (Scopus)

Resumen

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.

Idioma original	English
Páginas (desde-hasta)	275-283
Número de páginas	9
Publicación	Journal of Perinatology
Volumen	40
N.º	2
DOI	https://doi.org/10.1038/s41372-019-0551-2
Estado	Published - feb. 1 2020
Publicado de forma externa	Sí

Nota bibliográfica

Funding Information:
Canadian Neonatal Network Investigators Prakesh S. Shah8, Jaideep Kanungo9, Joseph Ting10, Zenon Cieslak11, Rebecca Sherlock12, Ayman Abou Mehrem13, Jennifer Toye14, Carlos Fajardo15, Zarin Kalapesi16, Jaya Bodani16, Koravangattu Sankaran17, Sibasis Daspal17, Mary Seshia18, Deepak Louis18, Ruben Alvaro19, Amit Mukerji20, Orlando Da Silva21, Mohammad Adie22, Kyong-Soon Lee23, Michael Dunn24, Brigitte Lemyre25, Faiza Khurshid26, Ermelinda Pelausa27, Keith Barrington28, Anie Lapoint28, Guillaume Ethier28, Christine Drolet29, Bruno Piedboeuf29, Martine Claveau30, Marc Beltempo30, Valerie Bertelle31, Edith Masse31, Roderick Canning32, Hala Makary33, Cecil Ojah34, Luis Monterrosa34, Julie Emberley35, Jehier Afifi36, Andrzej Kajetanowicz37, Shoo K. Lee38 8Mount Sinai Hospital, Toronto, ON, Canada; 9Victoria General Hospital, Victoria, BC, Canada; 10B.C. Women’s Hospital and Health Centre, Vancouver, BC, Canada; 11Royal Columbian Hospital, New Westminster, BC, Canada; 12Surrey Memorial Hospital, Surrey, BC, Canada; 13Foothills Medical Centre, Calgary, AB, Canada; 14Royal Alexandra Hospital, Edmonton, AB, Canada; 15Alberta Children’s Hospital, Calgary, AB, Canada; 16Regina General Hospital, Regina, SK, Canada; 17Royal University Hospital, Saskatoon, SK, Canada; 18Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 19St. Boniface General Hospital, Winnipeg, MB, Canada;20Hamilton Health Sciences Centre, Hamilton, ON, Canada; 21London Health Sciences Centre, London, ON, Canada; 22Windsor Regional Hospital, Windsor, ON, Canada; 23Hospital for Sick Children, Toronto, ON, Canada; 24Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 25Children’s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 26Kingston General Hospital, Kingston, ON, Canada;27Jewish General Hospital, Montréal, QC, Canada; 28Hôpital Sainte-Justine, Montréal, QC, Canada; 29Centre Hospitalier Universitaire de Québec, Sainte Foy, QC, Canada; 30Montreal Children’s Hospital at McGill University Health Centre, Montréal, QC, Canada; 31Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 32Moncton Hospital, Moncton, NB, Canada; 33Dr. Everett Chalmers Hospital, Fredericton, NB, Canada; 34Saint John Regional Hospital, Saint John, NB, Canada; 35Janeway Children’s Health and Rehabilitation Centre, St. John’s, NL, Canada; 36IWK Health Centre, Halifax, NS, Canada; 37Cape Breton Regional Hospital, Sydney, NS, Canada; 38Mount Sinai Hospital, Toronto, ON, Canada Funding Organizational support for the Canadian Neonatal Network was provided by the Maternal-infant Care (MiCare) Research Centre at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR) (CTP 87518), by the Ontario Ministry of Health and Long-Term Care, and by the participating hospitals. PSS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340).

Publisher Copyright:
© 2019, The Author(s), under exclusive licence to Springer Nature America, Inc.

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynaecology

PubMed: MeSH publication types

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

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10.1038/s41372-019-0551-2

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@article{62bdc3b5a7454a3fa8a5ec4e2867abf3,

title = "Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia",

abstract = "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{\textquoteright} 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.",

author = "{on behalf of the Canadian Neonatal Network Investigators} and Goswami, {Ipsita R.} and Hilary Whyte and Pia Wintermark and Khorshid Mohammad and Sandesh Shivananda and Deepak Louis and Yoon, {Eugene W.} and Shah, {Prakesh S.} and Jaideep Kanungo and Joseph Ting and Zenon Cieslak and Rebecca Sherlock and Mehrem, {Ayman Abou} and Jennifer Toye and Carlos Fajardo and Zarin Kalapesi and Jaya Bodani and Koravangattu Sankaran and Sibasis Daspal and Mary Seshia and Deepak Louis and Ruben Alvaro and Amit Mukerji and {Da Silva}, Orlando and Mohammad Adie and Lee, {Kyong Soon} and Michael Dunn and Brigitte Lemyre and Faiza Khurshid and Ermelinda Pelausa and Keith Barrington and Anie Lapoint and Guillaume Ethier and Christine Drolet and Bruno Piedboeuf and Martine Claveau and Marc Beltempo and Valerie Bertelle and Edith Masse and Roderick Canning and Hala Makary and Cecil Ojah and Luis Monterrosa and Julie Emberley and Jehier Afifi and Andrzej Kajetanowicz and Lee, {Shoo K.}",

note = "Funding Information: Canadian Neonatal Network Investigators Prakesh S. Shah8, Jaideep Kanungo9, Joseph Ting10, Zenon Cieslak11, Rebecca Sherlock12, Ayman Abou Mehrem13, Jennifer Toye14, Carlos Fajardo15, Zarin Kalapesi16, Jaya Bodani16, Koravangattu Sankaran17, Sibasis Daspal17, Mary Seshia18, Deepak Louis18, Ruben Alvaro19, Amit Mukerji20, Orlando Da Silva21, Mohammad Adie22, Kyong-Soon Lee23, Michael Dunn24, Brigitte Lemyre25, Faiza Khurshid26, Ermelinda Pelausa27, Keith Barrington28, Anie Lapoint28, Guillaume Ethier28, Christine Drolet29, Bruno Piedboeuf29, Martine Claveau30, Marc Beltempo30, Valerie Bertelle31, Edith Masse31, Roderick Canning32, Hala Makary33, Cecil Ojah34, Luis Monterrosa34, Julie Emberley35, Jehier Afifi36, Andrzej Kajetanowicz37, Shoo K. Lee38 8Mount Sinai Hospital, Toronto, ON, Canada; 9Victoria General Hospital, Victoria, BC, Canada; 10B.C. Women{\textquoteright}s Hospital and Health Centre, Vancouver, BC, Canada; 11Royal Columbian Hospital, New Westminster, BC, Canada; 12Surrey Memorial Hospital, Surrey, BC, Canada; 13Foothills Medical Centre, Calgary, AB, Canada; 14Royal Alexandra Hospital, Edmonton, AB, Canada; 15Alberta Children{\textquoteright}s Hospital, Calgary, AB, Canada; 16Regina General Hospital, Regina, SK, Canada; 17Royal University Hospital, Saskatoon, SK, Canada; 18Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 19St. Boniface General Hospital, Winnipeg, MB, Canada;20Hamilton Health Sciences Centre, Hamilton, ON, Canada; 21London Health Sciences Centre, London, ON, Canada; 22Windsor Regional Hospital, Windsor, ON, Canada; 23Hospital for Sick Children, Toronto, ON, Canada; 24Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 25Children{\textquoteright}s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 26Kingston General Hospital, Kingston, ON, Canada;27Jewish General Hospital, Montr{\'e}al, QC, Canada; 28H{\^o}pital Sainte-Justine, Montr{\'e}al, QC, Canada; 29Centre Hospitalier Universitaire de Qu{\'e}bec, Sainte Foy, QC, Canada; 30Montreal Children{\textquoteright}s Hospital at McGill University Health Centre, Montr{\'e}al, QC, Canada; 31Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 32Moncton Hospital, Moncton, NB, Canada; 33Dr. Everett Chalmers Hospital, Fredericton, NB, Canada; 34Saint John Regional Hospital, Saint John, NB, Canada; 35Janeway Children{\textquoteright}s Health and Rehabilitation Centre, St. John{\textquoteright}s, NL, Canada; 36IWK Health Centre, Halifax, NS, Canada; 37Cape Breton Regional Hospital, Sydney, NS, Canada; 38Mount Sinai Hospital, Toronto, ON, Canada Funding Organizational support for the Canadian Neonatal Network was provided by the Maternal-infant Care (MiCare) Research Centre at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR) (CTP 87518), by the Ontario Ministry of Health and Long-Term Care, and by the participating hospitals. PSS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340). Publisher Copyright: {\textcopyright} 2019, The Author(s), under exclusive licence to Springer Nature America, Inc.",

year = "2020",

month = feb,

day = "1",

doi = "10.1038/s41372-019-0551-2",

language = "English",

volume = "40",

pages = "275--283",

journal = "Journal of Perinatology",

issn = "0743-8346",

publisher = "Nature Publishing Group",

number = "2",

}

TY - JOUR

T1 - Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia

AU - on behalf of the Canadian Neonatal Network Investigators

AU - Goswami, Ipsita R.

AU - Whyte, Hilary

AU - Wintermark, Pia

AU - Mohammad, Khorshid

AU - Shivananda, Sandesh

AU - Louis, Deepak

AU - Yoon, Eugene W.

AU - Shah, Prakesh S.

AU - Kanungo, Jaideep

AU - Ting, Joseph

AU - Cieslak, Zenon

AU - Sherlock, Rebecca

AU - Mehrem, Ayman Abou

AU - Toye, Jennifer

AU - Fajardo, Carlos

AU - Kalapesi, Zarin

AU - Bodani, Jaya

AU - Sankaran, Koravangattu

AU - Daspal, Sibasis

AU - Seshia, Mary

AU - Louis, Deepak

AU - Alvaro, Ruben

AU - Mukerji, Amit

AU - Da Silva, Orlando

AU - Adie, Mohammad

AU - Lee, Kyong Soon

AU - Dunn, Michael

AU - Lemyre, Brigitte

AU - Khurshid, Faiza

AU - Pelausa, Ermelinda

AU - Barrington, Keith

AU - Lapoint, Anie

AU - Ethier, Guillaume

AU - Drolet, Christine

AU - Piedboeuf, Bruno

AU - Claveau, Martine

AU - Beltempo, Marc

AU - Bertelle, Valerie

AU - Masse, Edith

AU - Canning, Roderick

AU - Makary, Hala

AU - Ojah, Cecil

AU - Monterrosa, Luis

AU - Emberley, Julie

AU - Afifi, Jehier

AU - Kajetanowicz, Andrzej

AU - Lee, Shoo K.

N1 - Funding Information: Canadian Neonatal Network Investigators Prakesh S. Shah8, Jaideep Kanungo9, Joseph Ting10, Zenon Cieslak11, Rebecca Sherlock12, Ayman Abou Mehrem13, Jennifer Toye14, Carlos Fajardo15, Zarin Kalapesi16, Jaya Bodani16, Koravangattu Sankaran17, Sibasis Daspal17, Mary Seshia18, Deepak Louis18, Ruben Alvaro19, Amit Mukerji20, Orlando Da Silva21, Mohammad Adie22, Kyong-Soon Lee23, Michael Dunn24, Brigitte Lemyre25, Faiza Khurshid26, Ermelinda Pelausa27, Keith Barrington28, Anie Lapoint28, Guillaume Ethier28, Christine Drolet29, Bruno Piedboeuf29, Martine Claveau30, Marc Beltempo30, Valerie Bertelle31, Edith Masse31, Roderick Canning32, Hala Makary33, Cecil Ojah34, Luis Monterrosa34, Julie Emberley35, Jehier Afifi36, Andrzej Kajetanowicz37, Shoo K. Lee38 8Mount Sinai Hospital, Toronto, ON, Canada; 9Victoria General Hospital, Victoria, BC, Canada; 10B.C. Women’s Hospital and Health Centre, Vancouver, BC, Canada; 11Royal Columbian Hospital, New Westminster, BC, Canada; 12Surrey Memorial Hospital, Surrey, BC, Canada; 13Foothills Medical Centre, Calgary, AB, Canada; 14Royal Alexandra Hospital, Edmonton, AB, Canada; 15Alberta Children’s Hospital, Calgary, AB, Canada; 16Regina General Hospital, Regina, SK, Canada; 17Royal University Hospital, Saskatoon, SK, Canada; 18Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 19St. Boniface General Hospital, Winnipeg, MB, Canada;20Hamilton Health Sciences Centre, Hamilton, ON, Canada; 21London Health Sciences Centre, London, ON, Canada; 22Windsor Regional Hospital, Windsor, ON, Canada; 23Hospital for Sick Children, Toronto, ON, Canada; 24Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 25Children’s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 26Kingston General Hospital, Kingston, ON, Canada;27Jewish General Hospital, Montréal, QC, Canada; 28Hôpital Sainte-Justine, Montréal, QC, Canada; 29Centre Hospitalier Universitaire de Québec, Sainte Foy, QC, Canada; 30Montreal Children’s Hospital at McGill University Health Centre, Montréal, QC, Canada; 31Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 32Moncton Hospital, Moncton, NB, Canada; 33Dr. Everett Chalmers Hospital, Fredericton, NB, Canada; 34Saint John Regional Hospital, Saint John, NB, Canada; 35Janeway Children’s Health and Rehabilitation Centre, St. John’s, NL, Canada; 36IWK Health Centre, Halifax, NS, Canada; 37Cape Breton Regional Hospital, Sydney, NS, Canada; 38Mount Sinai Hospital, Toronto, ON, Canada Funding Organizational support for the Canadian Neonatal Network was provided by the Maternal-infant Care (MiCare) Research Centre at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR) (CTP 87518), by the Ontario Ministry of Health and Long-Term Care, and by the participating hospitals. PSS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340). Publisher Copyright: © 2019, The Author(s), under exclusive licence to Springer Nature America, Inc.

PY - 2020/2/1

Y1 - 2020/2/1

N2 - 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.

AB - 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.

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Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia

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ASJC Scopus Subject Areas

PubMed: MeSH publication types

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