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围产期窒息后接受降温治疗的新生儿中,温度变异性与磁共振成像显示的脑损伤之间的关系。

Relationship between temperature variability and brain injury on magnetic resonance imaging in cooled newborn infants after perinatal asphyxia.

作者信息

Brotschi B, Gunny R, Rethmann C, Held U, Latal B, Hagmann C

机构信息

Department of Pediatric and Neonatal Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.

Department of Pediatric Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

出版信息

J Perinatol. 2017 Sep;37(9):1032-1037. doi: 10.1038/jp.2017.96. Epub 2017 Jun 15.

Abstract

OBJECTIVE

The objective of the study was whether temperature management during therapeutic hypothermia correlates with the severity of brain injury assessed on magnetic resonance imaging in term infants with hypoxic-ischemic encephalopathy.

STUDY DESIGN

Prospectively collected register data from the National Asphyxia and Cooling Register of Switzerland were analyzed.

RESULT

Fifty-five newborn infants were cooled for 72 h with a target temperature range of 33 to 34 °C. Individual temperature variability (odds ratio (OR) 40.17 (95% confidence interval (CI) 1.37 to 1037.67)) and percentage of temperatures within the target range (OR 0.95 (95% CI 0.90 to 0.98)) were associated with the severity of brain injury seen on magnetic resonance imaging (MRI). Neither the percentage of measured temperatures above (OR 1.08 (95% CI 0.96 to 1.21)) nor below (OR 0.99 (95% CI 0.92 to 1.07) the target range was associated with the severity of brain injury seen on MRI.

CONCLUSION

In a national perinatal asphyxia cohort, temperature variability and percentage of temperatures within the target temperature range were associated with the severity of brain injury.

摘要

目的

本研究的目的是探讨治疗性低温期间的体温管理与足月缺氧缺血性脑病婴儿磁共振成像评估的脑损伤严重程度之间是否存在关联。

研究设计

分析了从瑞士国家窒息与降温登记处前瞻性收集的登记数据。

结果

55例新生儿接受了72小时的降温治疗,目标温度范围为33至34°C。个体体温变异性(优势比(OR)40.17(95%置信区间(CI)1.37至1037.67))和目标范围内体温的百分比(OR 0.95(95%CI 0.90至0.98))与磁共振成像(MRI)显示的脑损伤严重程度相关。测量温度高于目标范围的百分比(OR 1.08(95%CI 0.96至1.21))和低于目标范围的百分比(OR 0.99(95%CI 0.92至1.07))均与MRI显示的脑损伤严重程度无关。

结论

在一个全国围产期窒息队列中,体温变异性和目标温度范围内体温的百分比与脑损伤严重程度相关。

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