Predictive factors of death in neonates with hypoxic-ischemic encephalopathy receiving selective head cooling

• Main Authors: Behnaz Basiri, Mohammadkazem Sabzehei, Mohammadmahdi sabahi
• Format: Article
• Language: English
• Published: The Korean Pediatric Society 2021-04-01
• Series: Clinical and Experimental Pediatrics
• Subjects: death; hypothermia; brain hypoxia-ischemia; newborn infant; prognosis
• Online Access: http://www.e-cep.org/upload/pdf/cep-2019-01382.pdf

Background Severe perinatal asphyxia results in multiple organ involvement, neonate hospitalization, and eventual death. Purpose This study aimed to investigate the predictive factors of death in newborns with hypoxic-ischemic encephalopathy (HIE) receiving selective head cooling. Methods This cross-sectional descriptive-retrospective study was conducted from 2013 to 2018 in Fatemieh Hospital of Hamadan and included 51 newborns who were admitted to the neonatal intensive care unit with a diagnosis of HIE. Selective head cooling for patients with moderate to severe HIE began within 6 hours of birth and continued for 72 hours. The required data for the predictive factors of death were extracted from the patients’ medical files, recorded on a premade form, and analyzed using SPSS ver. 16. Results Of the 51 neonates with moderate to severe HIE who were treated with selective head cooling, 16 (31%) died. There were significant relationships between death and the need for advanced neonatal resuscitation (P=0.002), need for mechanical ventilation (P=0.016), 1-minute Apgar score (P=0.040), and severely abnormal amplitude-integrated electroencephalography (a-EEG) (P=0.047). Multiple regression of variables or data showed that the need for advanced neonatal resuscitation was an independent predictive factor of death (P=0.0075) and severely abnormal a-EEG was an independent predictive factor of asphyxia severity (P=0.0001). Conclusion All cases of neonatal death in our study were severe HIE (stage 3). Advanced neonatal resuscitation was an independent predictor of death, while a severely abnormal a-EEG was an independent predictor of asphyxia severity in infants with HIE.