Basiri Behnaz, Sabzehei Mohammadkazem, Sabahi Mohammadmahdi
Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran.
Neurosurgery Research Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
Clin Exp Pediatr. 2021 Apr;64(4):180-187. doi: 10.3345/cep.2019.01382. Epub 2020 Aug 27.
Severe perinatal asphyxia results in multiple organ involvement, neonate hospitalization, and eventual death.
This study aimed to investigate the predictive factors of death in newborns with hypoxic-ischemic encephalopathy (HIE) receiving selective head cooling.
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.
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).
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.
严重围产期窒息会导致多器官受累、新生儿住院，最终导致死亡。
本研究旨在探讨接受选择性头部降温的缺氧缺血性脑病（HIE）新生儿死亡的预测因素。
本横断面描述性回顾性研究于2013年至2018年在哈马丹的法特米耶医院进行，纳入了51例诊断为HIE并入住新生儿重症监护病房的新生儿。对中重度HIE患者在出生后6小时内开始选择性头部降温，并持续72小时。从患者的医疗档案中提取死亡预测因素所需的数据，记录在预先制作的表格上，并使用SPSS 16.0版进行分析。
在51例接受选择性头部降温治疗的中重度HIE新生儿中，16例（31%）死亡。死亡与需要进行高级新生儿复苏（P=0.002）、需要机械通气（P=0.016）、1分钟阿氏评分（P=0.040）以及振幅整合脑电图（a-EEG）严重异常（P=0.047）之间存在显著关系。变量或数据的多元回归显示，需要进行高级新生儿复苏是死亡的独立预测因素（P=0.0075），而a-EEG严重异常是窒息严重程度的独立预测因素（P=0.0001）。
我们研究中的所有新生儿死亡病例均为重度HIE（3期）。高级新生儿复苏是死亡的独立预测因素，而a-EEG严重异常是HIE婴儿窒息严重程度的独立预测因素。
