Outcome of infants with hypoxic ischemic encephalopathy treated with brain hypothermia.

AimThe aim of this study was to determine perinatal factors associated with cerebral palsy (CP) in infants treated with brain hypothermia (BHT). Material and MethodsWe carried out a retrospective review of 23 infants with hypoxic ischemic encephalopathy in whom BHT was applied within 6h after birth. Outcome regarding the presence or absence of CP was assessed at the age of 18 months. Oxygen extraction fraction (OEF) was measured before, during and after BHT at the jugular sinus. ResultsThree infants died and 12 developed CP (poor outcome group). The remaining eight infants did not have CP at 18 months old (favorable outcome group). There were no differences in gestational age, birthweight, pH, base deficit, or lactate level between infants with favorable and poor outcomes. Infants with flat trace on electroencephalography on admission were less likely to have favorable outcome (0.0% [0/8] vs 53% [8/15], respectively, P=0.02), while those with Apgar score at 10min 5 (57% [8/14] vs 0.0% [0/9], P=0.007) or 6 (70% [7/10] vs 7.7% [1/13], P=0.002), OEF13.3% during BHT (64% [7/11] vs 8.3% [1/12], P=0.009), and OEF18.5% after BHT (73% [8/11] vs 0.0% [0/12], P=0.002) were more likely to have favorable outcome compared with those with counterpart characteristics. ConclusionInfants with an Apgar score at 10min 5, activity on electroencephalography on admission, and higher OEF during and after BHT were likely to have a favorable outcome.