Pediatrics, Central Michigan University, Children's Hospital of Michigan, Detroit, MI, USA.
Pediatrics, Emory University, Atlanta, GA, USA.
J Perinatol. 2022 Aug;42(8):1017-1025. doi: 10.1038/s41372-022-01400-x. Epub 2022 Apr 26.
To assess the association between opioid exposure during therapeutic hypothermia (TH) for perinatal hypoxic-ischemic encephalopathy (HIE) and in-hospital outcomes.
In this retrospective cohort study, linked data were accessed on infants ≥36 weeks gestation, who underwent TH for HIE, born from 2010-2016 in 23 Neonatal Intensive Care Units participating in Children's Hospitals Neonatal Consortium and Pediatric Health Information Systems. We excluded infants who received opioids for >5 days.
The cohort (n = 1484) was categorized as No opioid [240(16.2%)], Low opioid (1-2 days) [574 (38.7%)] and High opioid group (HOG, 3-5 days) [670 (45.2%)]. After adjusting for HIE severity, opioids were not associated with abnormal MRI, but were associated with decreased likelihood of complete oral feeds at discharge. HOG had increased likelihood of prolonged hospital stay and ventilation.
Opioid exposure during TH was not associated with abnormal MRI; its association with adverse short-term outcomes suggests need for cautious empiric use.
评估围产期缺氧缺血性脑病（HIE）治疗性低温（TH）期间阿片类药物暴露与住院结局的关系。
在这项回顾性队列研究中，我们查阅了 2010 年至 2016 年期间在参与儿童医院新生儿联盟和儿科健康信息系统的 23 个新生儿重症监护病房接受 HIE 治疗性低温的胎龄≥36 周的婴儿的相关数据。我们排除了接受阿片类药物治疗>5 天的婴儿。
队列（n=1484）分为无阿片类药物[240（16.2%）]、低阿片类药物（1-2 天）[574（38.7%）]和高阿片类药物组（HOG，3-5 天）[670（45.2%）]。在调整了 HIE 严重程度后，阿片类药物与异常 MRI 无关，但与出院时完全口服喂养的可能性降低有关。HOG 有延长住院时间和通气的可能性。
TH 期间阿片类药物暴露与异常 MRI 无关；其与不良短期结局的关联表明需要谨慎经验性使用。
