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Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience
| Resumo: | 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. |
|---|---|
| Autores principais: | Sequeira, Ana Teresa |
| Outros Autores: | Gil, Joana; Sampaio, Isabel; Moniz, Carlos; M. Graça, Andre |
| Assunto: | Original articles |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Sociedade Portuguesa de Pediatria |
| Idioma: | inglês |
| Origem: | Portuguese Journal of Pediatrics |
| _version_ | 1868077505875804160 |
|---|---|
| author | Sequeira, Ana Teresa |
| author2 | Gil, Joana Sampaio, Isabel Moniz, Carlos M. Graça, Andre |
| author2_role | author author author author |
| author_facet | Sequeira, Ana Teresa Gil, Joana Sampaio, Isabel Moniz, Carlos M. Graça, Andre |
| author_role | author |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Sequeira, Ana Teresa\"},{\"Person.name\":\"Gil, Joana\"},{\"Person.name\":\"Sampaio, Isabel\"},{\"Person.name\":\"Moniz, Carlos\"},{\"Person.name\":\"M. Graça, Andre\"}] |
| datacite.creators.creator.creatorName.fl_str_mv | Sequeira, Ana Teresa Gil, Joana Sampaio, Isabel Moniz, Carlos M. Graça, Andre |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Original articles |
| datacite.titles.title.fl_str_mv | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience Hipotermia induzida na encefalopatia hipóxico-isquémica |
| dc.creator.none.fl_str_mv | Sequeira, Ana Teresa Gil, Joana Sampaio, Isabel Moniz, Carlos M. Graça, Andre |
| dc.identifier.none.fl_str_mv | https://ojs.pjp.spp.pt/article/view/20006 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Sociedade Portuguesa de Pediatria |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.rights.rights.copyright.fl_str_mv | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
| dc.subject.none.fl_str_mv | Original articles |
| dc.title.fl_str_mv | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience Hipotermia induzida na encefalopatia hipóxico-isquémica |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | 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. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| id | app_e5ee04b8a16b5964ff56801eace5c2aa |
| identifier.url.fl_str_mv | https://ojs.pjp.spp.pt/article/view/20006 |
| instacron_str | spp |
| institution | Sociedade Portuguesa de Pediatria |
| instname_str | Sociedade Portuguesa de Pediatria |
| language | eng |
| network_acronym_str | app |
| network_name_str | Portuguese Journal of Pediatrics |
| oai_identifier_str | oai:ojs.revistas.rcaap.pt:article/20006 |
| organization_str_mv | urn:organizationAcronym:spp |
| person_str_mv | Sequeira, Ana Teresa Gil, Joana Sampaio, Isabel Moniz, Carlos M. Graça, Andre |
| publishDate | 2021 |
| publisher.none.fl_str_mv | Sociedade Portuguesa de Pediatria |
| reponame_str | Portuguese Journal of Pediatrics |
| repository_id_str | urn:repositoryAcronym:app |
| service_str_mv | urn:repositoryAcronym:app |
| spelling | Sociedade Portuguesa de PediatriaenIntroduction: 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.engenTherapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year ExperienceptHipotermia induzida na encefalopatia hipóxico-isquémicaTranslatedTitleSequeira, Ana TeresaSequeiraAna TeresaDepartamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalGil, JoanaGilJoanaServiço de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalSampaio, IsabelSampaioIsabelServiço de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal / Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalMoniz, CarlosMonizCarlosServiço de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal / Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalM. Graça, AndreM. GraçaAndreServiço de Neonatologia, Departamento de Pediatria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal / Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalEISSN2184-4453IsPartOfPISSN2184-3333IsPartOf2021-02-26URLhttps://ojs.pjp.spp.pt/article/view/20006http://purl.org/coar/access_right/c_abf2open accessOriginal articleshttp://purl.org/coar/resource_type/c_6501journal articlehttp://creativecommons.org/licenses/by-nc-nd/4.0This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.2021-02-26fulltextapplication/pdfPortuguese Journal of Pediatrics521 |
| spellingShingle | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience Sequeira, Ana Teresa Original articles |
| status | SINGLETON |
| subject.fl_str_mv | Original articles |
| title | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience |
| title_full | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience |
| title_fullStr | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience |
| title_full_unstemmed | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience |
| title_short | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience |
| title_sort | Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: 10-Year Experience |
| topic | Original articles |
| topic_facet | Original articles |
| url | https://ojs.pjp.spp.pt/article/view/20006 |
| visible | 1 |