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

被引：4

作者：

Shankaran, Seetha ^{[1
]}

Barnes, Patrick D. ^{[2
]}

Hintz, Susan R. ^{[3
]}

Laptook, Abbott R. ^{[4
]}

Zaterka-Baxter, Kristin M. ^{[5
]}

McDonald, Scott A. ^{[6
]}

Ehrenkranz, Richard A. ^{[7
]}

Walsh, Michele C. ^{[8
]}

Tyson, Jon E. ^{[9
]}

Donovan, Edward F. ^{[10
]}

Goldberg, Ronald N. ^{[11
]}

Bara, Rebecca ^{[12
]}

Das, Abhik ^{[6
]}

Finer, Neil N. ^{[13
]}

Sanchez, Pablo J. ^{[14
]}

Poindexter, Brenda B. ^{[15
]}

Van Meurs, Krisa P. ^{[16
]}

Carlo, Waldemar A. ^{[17
]}

Stoll, Barbara J. ^{[18
]}

Duara, Shahnaz ^{[19
]}

Guillet, Ronnie ^{[20
]}

Higgins, Rosemary D. ^{[21
]}

机构：

[1] Wayne State Univ, Childrens Hosp Michigan, Dept Pediat Neonatol, Detroit, MI 48201 USA

[2] Stanford Univ, Sch Med, Dept Radiol & Pediat, Palo Alto, CA 94304 USA

[3] Stanford Univ, Sch Med, Dept Pediat, Palo Alto, CA 94304 USA

[4] Brown Univ, Women & Infants Hosp, Dept Pediat, Providence, RI 02908 USA

[5] RTI Int, Dept Stat & Epidemiol, Research Pk, NC USA

[6] RTI Int, Stat & Epidemiol, Research Pk, NC USA

[7] Yale Univ, Sch Med, Dept Pediat, New Haven, CT 06510 USA

[8] Case Western Reserve Univ, Dept Pediat, Cleveland, OH 44106 USA

[9] Univ Texas Houston, Med Sch Houston, Ctr Clin Res & Evidence Based Med, Houston, TX USA

[10] Univ Cincinnati, Dept Pediat, Cincinnati, OH 45221 USA

[11] Duke Univ, Dept Pediat, Durham, NC 27706 USA

[12] Wayne State Univ, Sch Med, Dept Pediat, Detroit, MI 48201 USA

[13] Univ Calif San Diego, Med Ctr, Dept Paediat Neonatol, La Jolla, CA 92093 USA

[14] Univ Texas SW Med Ctr Dallas, Dept Pediat, Dallas, TX 75390 USA

[15] Indiana Univ Sch Med, Dept Pediat, Indianapolis, IN USA

[16] Lucile Packard Childrens Hosp, Div Neonatol, Palo Alto, CA USA

[17] Univ Alabama Birmingham, Dept Pediat, Birmingham, AL USA

[18] Emory Univ, Sch Med, Dept Pediat, Atlanta, GA USA

[19] Univ Miami, Miller Sch Med, Dept Pediat, Miami, FL 33136 USA

[20] Univ Rochester, Sch Med & Dent, Rochester, NY USA

[21] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD USA

来源：

ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION | 2012年 / 97卷 / 06期

基金：

美国国家卫生研究院;

关键词：

WHOLE-BODY HYPOTHERMIA; SYSTEMIC HYPOTHERMIA; TERM NEWBORNS; MRI; PATTERNS; INFANTS; AGE;

D O I：

暂无

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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.

引用

页码：F398 / F404

页数：7

共 24 条

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