University of Michigan, Ann Arbor, MI, USA.
Neonatal-Perinatal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
J Perinatol. 2021 Mar;41(3):512-518. doi: 10.1038/s41372-020-00873-y. Epub 2020 Nov 22.
To test the hypothesis that brainstem hypoxic-ischemic injury on magnetic resonance imaging (MRI) would be independently associated with short-term outcomes in cooled asphyxiated infants.
A total of 90 consecutively cooled asphyxiated infants who survived to have brain MRI were reviewed. A neuroradiologist who was masked to outcomes evaluated MRI images for brainstem involvement. Outcomes were mortality and length of stay.
Brainstem lesions were present on post-cooling brain MRI in 20 of the 90 infants (22%). Overall, four infants died before discharge, and all four had brainstem involvement. The infants with brainstem involvement had longer hospital stay (29 days, IQR 20-47 versus 16 days, IQR 10-26; P = 0.0001), compared to infants without brainstem lesions (n = 70); and upon multivariate analysis, brainstem involvement remained independently associated with prolonged hospital stay (β = 12.4, P = 0.001).
This study demonstrates the importance of recognizing brainstem injury for the prediction of short-term outcomes in cooled asphyxiated infants.
验证假设，即在磁共振成像（MRI）上显示的脑干缺氧缺血性损伤与冷却后窒息婴儿的短期结局独立相关。
回顾了 90 例连续接受冷却治疗的窒息存活婴儿，这些婴儿都进行了脑 MRI 检查。一位对结果不知情的神经放射科医生对 MRI 图像进行了评估，以确定脑干是否受累。结局是死亡率和住院时间。
在 90 例接受冷却治疗的婴儿中，有 20 例（22%）在冷却后 MRI 上出现了脑干病变。总的来说，有 4 例婴儿在出院前死亡，而且这 4 例婴儿都有脑干受累。与无脑干病变的婴儿（n=70）相比，有脑干受累的婴儿的住院时间更长（29 天，IQR 20-47 与 16 天，IQR 10-26；P=0.0001）；并且在多变量分析中，脑干受累仍然与住院时间延长独立相关（β=12.4，P=0.001）。
这项研究表明，在冷却后窒息婴儿中，识别脑干损伤对于预测短期结局非常重要。
