Multiorgan dysfunction in infants of 33-35 weeks gestation with severe hypoxic-ischemic encephalopathy treated with hypothermia anatomy & physiology
Background: The benefits of hypothermia on neurodevelopment of newborns ≥ 36 weeks gestation with hypoxicischemic encephalopathy have been shown in large clinical trials. The security of hypothermia in premature infants ≤ 36 weeks has not been rigorously evaluated, although its feasibility has been...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2018 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:20.500.12328/4032 |
| Acceso en línea: | http://hdl.handle.net/20.500.12328/4032 https://dx.doi.org/10.4172/2161-0940.1000305 |
| Access Level: | acceso abierto |
| Palabra clave: | Hipotèrmia Encefalopatia hipòxico-isquèmica Disfunció multiorgànica Òrgan-sistema Preterm Hipotermia Encefalopatía hipóxico-isquémica Disfunción multiorgánica Sistema de órganos Prematuro Hypothermia Hypoxic-ischemic encephalopathy Multiorgan dysfunction Organ-system 61 |
| Sumario: | Background: The benefits of hypothermia on neurodevelopment of newborns ≥ 36 weeks gestation with hypoxicischemic encephalopathy have been shown in large clinical trials. The security of hypothermia in premature infants ≤ 36 weeks has not been rigorously evaluated, although its feasibility has been suggested in recent studies. The present study aims: 1) To describe extraneural involvement in infants 33-35 weeks gestation with severe hypoxicischemic encephalopathy treated with hypothermia 2) To compare organ dysfunction with infants ≥ 36 weeks gestation. Methods: Retrospective observational study of prospective data collected. Consecutive newborns of 33-35 weeks gestation, ≥ 1800g birth weight and severe hypoxic-ischemic encephalopathy were included. Data were compared with a cohort of newborn infants ≥ 36 weeks with severe encephalopathy. Twenty clinical and laboratory variables of 6 organ-systems (cardiovascular, respiratory, renal, haematological, hepatic and pH and electrolytic imbalance) were studied and a multiorgan dysfunction scale was applied daily during the first 3 days of life. Results: Eight preterm newbors with severe HIE were compared with 31 term neonates with severe HIE. All infants presented with moderate-to-severe organ injury. There were no differences in most of organ variables, the number of affected organ-systems or the scores in the Multiorgan dysfunction Scale between both gestational age groups in the first 3 days of life (p>0.05). Conclusion: Organ injury in infants of 33-35 weeks gestation with severe HIE evaluated for hypothermia is not more severe regarding newborns ≥ 36 weeks gestation. Therapeutic hypothermia appears feasible in this gestational age group although clinical trials are needed to answer this question. |
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