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Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy.

CPQCC Publication
TitleBrain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy.
Publication TypeJournal Article
Year of Publication2012
AuthorsShankaran S, Barnes PD, Hintz SR, Laptook AR, Zaterka-Baxter KM, McDonald SA, Ehrenkranz RA, Walsh MC, Tyson JE, Donovan EF, Goldberg RN, Bara R, Das A, Finer NN, Sánchez PJ, Poindexter BB, Van Meurs KP, Carlo WA, Stoll BJ, Duara S, Guillet R, Higgins RD
Corporate AuthorsEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
JournalArch Dis Child Fetal Neonatal Ed
Volume97
Issue6
PaginationF398-404
Date Published2012 Nov
ISSN1468-2052
KeywordsBrain Injuries, Female, Humans, Hypothermia, Induced, Hypoxia-Ischemia, Brain, Infant, Infant, Newborn, Magnetic Resonance Imaging, Male, Severity of Illness Index, Treatment Outcome
Abstract

OBJECTIVE: The objective of our study was to examine the relationship between brain injury and outcome following neonatal hypoxic-ischaemic encephalopathy treated with hypothermia.

DESIGN AND PATIENTS: Neonatal MRI scans were evaluated in the National Institute of Child Health and Human Development (NICHD) randomised controlled trial of whole-body hypothermia and each infant was categorised based upon the pattern of brain injury on the MRI findings. Brain injury patterns were assessed as a marker of death or disability at 18-22 months of age.

RESULTS: Scans were obtained on 136 of 208 trial participants (65%); 73 in the hypothermia and 63 in the control group. Normal scans were noted in 38 of 73 infants (52%) in the hypothermia group and 22 of 63 infants (35%) in the control group. Infants in the hypothermia group had fewer areas of infarction (12%) compared to infants in the control group (22%). Fifty-one of the 136 infants died or had moderate or severe disability at 18 months. The brain injury pattern correlated with outcome of death or disability and with disability among survivors. Each point increase in the severity of the pattern of brain injury was independently associated with a twofold increase in the odds of death or disability.

CONCLUSIONS: Fewer areas of infarction and a trend towards more normal scans were noted in brain MRI following whole-body hypothermia. Presence of the NICHD pattern of brain injury is a marker of death or moderate or severe disability at 18-22 months following hypothermia for neonatal encephalopathy.

DOI10.1136/archdischild-2011-301524
Alternate JournalArch Dis Child Fetal Neonatal Ed
PubMed ID23080477
PubMed Central IDPMC3722585
Grant ListU10 HD027856 / HD / NICHD NIH HHS / United States
U10 HD021373 / HD / NICHD NIH HHS / United States
U10 HD021385 / HD / NICHD NIH HHS / United States
U10 HD021364 / HD / NICHD NIH HHS / United States
U10 HD027880 / HD / NICHD NIH HHS / United States
U10 HD040521 / HD / NICHD NIH HHS / United States
M01 RR008084 / RR / NCRR NIH HHS / United States
U10 HD040461 / HD / NICHD NIH HHS / United States
M01 RR016587 / RR / NCRR NIH HHS / United States
U10 HD040689 / HD / NICHD NIH HHS / United States
U10 HD040492 / HD / NICHD NIH HHS / United States
U10 HD027853 / HD / NICHD NIH HHS / United States
U10 HD027904 / HD / NICHD NIH HHS / United States
U10 HD021397 / HD / NICHD NIH HHS / United States
UL1 TR000454 / TR / NCATS NIH HHS / United States
U10 HD027871 / HD / NICHD NIH HHS / United States
U10 HD027851 / HD / NICHD NIH HHS / United States
U10 HD034216 / HD / NICHD NIH HHS / United States
U10 HD036790 / HD / NICHD NIH HHS / United States
M01 RR006022 / RR / NCRR NIH HHS / United States