亚低温治疗期间的毯温与缺氧缺血性脑病的结局。
Blanket temperature during therapeutic hypothermia and outcomes in hypoxic ischemic encephalopathy.
机构信息
Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Perinatol. 2022 Mar;42(3):348-353. doi: 10.1038/s41372-021-01302-4. Epub 2022 Jan 8.
OBJECTIVE
Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE).
STUDY DESIGN
Retrospective cohort study of 181 infants with HIE who received TH in two randomized trials within the Neonatal Research Network. We defined summative blanket temperature constructs and evaluated for association with a primary composite outcome of death or moderate/ severe disability at 18-22 months.
RESULTS
Each 0.5 °C above 33.5 °C in the mean of the highest quartile blanket temperature was associated with a 52% increase in the adjusted odds of death/ disability (aOR 1.52, 95% CI 1.09-2.11). Having >8 consecutive blanket temperatures above 33.5 °C rendered an aOR of death/disability of 5.04 in the first 24 h (95% CI 1.54-16.6) and 6.92 in the first 48 h (95% CI 2.20-21.8) of TH.
CONCLUSIONS
Higher blanket temperature during TH may be an early, clinically useful biomarker of HIE outcome.
目的
确定治疗性低体温（TH）期间的毯子温度是否与缺氧缺血性脑病（HIE）婴儿 18-22 个月的结局相关。
研究设计
这是一项在新生儿研究网络中的两项随机试验中接受 TH 的 181 例 HIE 婴儿的回顾性队列研究。我们定义了累积毯子温度结构，并评估了其与主要复合结局（18-22 个月时死亡或中度/重度残疾）的关联。
结果
最高四分位毯子温度的平均值每升高 0.5°C，死亡/残疾的调整比值比（aOR）就增加 52%（aOR 1.52，95%CI 1.09-2.11）。在前 24 小时内，连续 8 次以上毯子温度高于 33.5°C，首次 TH 的死亡/残疾比值比（aOR）为 5.04（95%CI 1.54-16.6），前 48 小时为 6.92（95%CI 2.20-21.8）。
结论
TH 期间较高的毯子温度可能是 HIE 结局的早期、临床有用的生物标志物。
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