Effects of Whole Body Therapeutic Hypothermia on Gastrointestinal Morbidity and Feeding Tolerance in Infants with Hypoxic Ischemic Encephalopathy

• Main Authors: Kimberly M. Thornton, Hongying Dai, Seth Septer, Joshua E. Petrikin
• Format: Article
• Language: English
• Published: Hindawi Limited 2014-01-01
• Series: International Journal of Pediatrics
• Online Access: http://dx.doi.org/10.1155/2014/643689
• ISSN: 1687-9740; 1687-9759

Objective. This retrospective cohort study evaluated the effects of whole body therapeutic hypothermia (WBTH) on gastrointestinal (GI) morbidity and feeding tolerance in infants with moderate-to-severe hypoxic ischemic encephalopathy (HIE). Study Design. Infants ≥ 35 weeks gestational age and ≥1800 grams birth weight with moderate-to-severe HIE treated from 2000 to 2012 were compared. 68 patients had documented strictly defined criteria for WBTH: 32 historical control patients did not receive WBTH (non-WBTH) and 36 cohort patients received WBTH. Result. More of the non-WBTH group infants never initiated enteral feeds (28% versus 6%; P=0.02), never reached full enteral feeds (38% versus 6%, P=0.002), and never reached full oral feeds (56% versus 19%, P=0.002). Survival analyses demonstrated that the WBTH group reached full enteral feeds (median time: 11 versus 9 days; P=0.02) and full oral feeds (median time: 19 versus 10 days; P=0.01) sooner. The non-WBTH group had higher combined outcomes of death and gastric tube placement (47% versus 11%; P=0.001) and death and gavage feeds at discharge (44% versus 11%; P=0.005). Conclusion. WBTH may have beneficial effects on GI morbidity and feeding tolerance for infants with moderate-to-severe HIE.