Autor(es): Sequeira, Ana Teresa ; Gil, Joana ; Sampaio, Isabel ; Moniz, Carlos ; Graca, Andre M.
Data: 2021
Identificador Persistente: http://hdl.handle.net/10451/46810
Origem: Repositório da Universidade de Lisboa
Assunto(s): Asphyxia neonatorum/complications; Hypothermia, induced/methods; Hypoxia-ischemia,brain/diagnostic imaging; Hypoxia-ischemia, brain/ therapy; Infant, newborn; Term birth; Portugal
Introduction: Therapeutic hypothermia (TH) is the standard of care treatment for brain injury following perinatal hypoxia-ischemia in term infants. Accumulated evidence from clinical trials, systematic reviews and continuous experience shows a reduction in both mortality and long-term neurodevelopmental disability. The aim of our study was to: (i) present the 10-year experience of the neonatal intensive care unit (NICU) that pioneered hypothermia program in Portugal; (ii) evaluate the use of neurologic monitoring and (iii) describe outcomes and adverse events. Methods: Prospective observational study of neonates who underwent TH between November 2009 and October 2019 in a single tertiary level NICU. Results: 128 newborns were treated. 91% were outborn. The median gestational age was 39 weeks. 91% neonates needed advanced resuscitation, and 22% prolonged resuscitation (>10 minutes). On admission, 60% had severe, 26% had moderate and 14% had mild encephalopathy. Hypotension was the most common complication, affecting 66% of the newborns. 21 (16%) patients died during hospital stay. Expected outcome based on aEEG and MRI was favorable in 40%, intermediate in 32% and adverse in 28%. Discussion: Effectiveness and safety profile of TH was confirmed in our population. A national register would be important to achieve and maintain high homogenous and national wide standards of care.
