Department of Pediatrics, Division of Neonatology, Children's Mercy Hospital, Kansas City, MO, USA.
Neonatal-Perinatal Medicine, The State University of New York, University at Buffalo, Buffalo, NY, USA.
J Neonatal Perinatal Med. 2020;13(4):463-468. doi: 10.3233/NPM-190332.
Stridor is one of the rare side effects of neonatal hypothermia treatment for hypoxic-ischemic encephalopathy. We aimed to describe the clinical characteristics of the infants who underwent whole-body hypothermia and developed stridor.
We reviewed the medical records of 171 infants with moderate or severe hypoxic-ischemic encephalopathy who underwent hypothermia therapy. Demographics, as well as clinical characteristics, were documented.
A total of 18 infants developed transient stridor out of 171 infants who underwent whole-body hypothermia (10.5%). The stridor was transient and resolved in all infants. All infants with stridor received treatment with one or more of the following: racemic epinephrine, dexamethasone, positive pressure ventilation and/or heliox. Two infants required otorhinolaryngologist (ENT) evaluation due to persistent and severe symptoms, of whom one was found to have left vocal cord paresis that improved with time.
Stridor is a transient complication associated with hypoxic-ischemic encephalopathy and whole-body hypothermia in neonates. The exact mechanism is unclear and most likely multifactorial. ENT evaluation is recommended in the presence of prolonged symptoms or significant respiratory distress.
喘鸣是新生儿缺氧缺血性脑病（HIE）治疗中发生的罕见的低温副作用之一。我们旨在描述接受全身低温治疗并发生喘鸣的婴儿的临床特征。
我们回顾了 171 例接受低温治疗的中重度 HIE 婴儿的病历。记录了人口统计学特征以及临床特征。
在 171 例接受全身低温治疗的婴儿中，共有 18 例（10.5%）出现短暂性喘鸣。喘鸣是一过性的，所有婴儿均得到缓解。所有喘鸣的婴儿均接受了以下一种或多种治疗：消旋肾上腺素、地塞米松、正压通气和/或氦氧混合气。由于持续存在严重症状，有 2 例婴儿需要耳鼻喉科（ENT）评估，其中 1 例患有左侧声带麻痹，随时间推移而改善。
喘鸣是新生儿缺氧缺血性脑病和全身低温治疗相关的短暂性并发症。确切的机制尚不清楚，可能是多因素的。如果存在持续时间长的症状或严重的呼吸窘迫，建议进行 ENT 评估。
