Comparative evaluation of approach to cardiovascular care in neonatal encephalopathy undergoing therapeutic hypothermia

J Perinatol. 2022 Dec;42(12):1637-1643. doi: 10.1038/s41372-022-01459-6. Epub 2022 Jul 20.

Abstract

Objective: To analyze the association between cardiovascular care and adverse outcome in infants undergoing therapeutic hypothermia for neonatal encephalopathy (NE).

Study design: This was a retrospective cohort study of 176 infants with NE and hypotension, admitted to the SickKids Hospital (Center A, n = 86) or Semmelweis University (Center B, n = 90).

Result: The lowest systolic/diastolic blood pressures were comparable amongst centers; however, proportion of cardiovascular support was lower in Center A (51% vs 97% in Center B). Overall rate of death or abnormal MRI (adverse outcome) were comparable between centers, although pattern differed with more basal ganglia injury in Center B. A 24-hour longer duration of cardiovascular support increased the odds for adverse outcome by 14%.

Conclusion: We demonstrated that management of hemodynamic instability in infants with NE was markedly different in two high-volume NICUs and showed that longer duration of cardiovascular medication is an independent risk factor for adverse outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Hypothermia, Induced* / adverse effects
  • Hypoxia-Ischemia, Brain* / diagnostic imaging
  • Hypoxia-Ischemia, Brain* / etiology
  • Hypoxia-Ischemia, Brain* / therapy
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases* / therapy
  • Intensive Care Units, Neonatal
  • Retrospective Studies