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Predictive factors of death in neonates with hypoxic-ischemic encephalopathy receiving selective head cooling

Clinical and Experimental Pediatrics 2021년 64권 4호 p.180 ~ 187
Basiri Behnaz, Sabzehei Mohammadkazem, Sabahi Mohammadmahdi,
소속 상세정보
 ( Basiri Behnaz ) - Hamadan University of Medical Sciences Department of Pediatrics
 ( Sabzehei Mohammadkazem ) - Hamadan University of Medical Sciences Department of Pediatrics
 ( Sabahi Mohammadmahdi ) - Hamadan University of Medical Sciences Students Research Committee

Abstract


Background: Severe perinatal asphyxia results in multiple organ involvement, neonate hospitalization, and eventual death.

Purpose: This study aimed to investigate the predictive factors of death in newborns with hypoxic-ischemic encephalopathy (HIE) receiving selective head cooling.

Methods: This cross-sectional descriptive-retrospective study was conducted from 2013 to 2018 in Fatemieh Hospital of Hamadan and included 51 newborns who were admitted to the neonatal intensive care unit with a diagnosis of HIE. Selective head cooling for patients with moderate to severe HIE began within 6 hours of birth and continued for 72 hours. The required data for the predictive factors of death were extracted from the patients’ medical files, recorded on a premade form, and analyzed using SPSS ver. 16.

Results: Of the 51 neonates with moderate to severe HIE who were treated with selective head cooling, 16 (31%) died. There were significant relationships between death and the need for advanced neonatal resuscitation (P=0.002), need for mechanical ventilation (P=0.016), 1-minute Apgar score (P=0.040), and severely abnormal amplitude-integrated electroencephalography (a-EEG) (P=0.047). Multiple regression of variables or data showed that the need for advanced neonatal resuscitation was an independent predictive factor of death (P=0.0075) and severely abnormal a-EEG was an independent predictive factor of asphyxia severity (P=0.0001).

Conclusion: All cases of neonatal death in our study were severe HIE (stage 3). Advanced neonatal resuscitation was an independent predictor of death, while a severely abnormal a-EEG was an independent predictor of asphyxia severity in infants with HIE.

키워드

Death; Hypothermia; Brain hypoxia-ischemia; Newborn infant; Prognosis

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