Fajardo Carlos, Belzu Marco, Bernal Benitez Manuel, Hoyos Ángela, Hernández Patiño Rubén, Monterrosa Luis, Villegas Carolina
Pediatrics, University of Calgary, Calgary, Alberta, Canada.
EpicLatino Neonatal Network, Calgary, Alberta, Canada.
Acta Paediatr. 2025 May;114(5):922-928. doi: 10.1111/apa.17504. Epub 2024 Nov 18.
A study reported that therapeutic hypothermia (TH) did not reduce the combined prognosis of mortality and disability at 18 months, in low- and middle-income countries for patients with hypoxic ischaemic encephalopathy (HIE) who received TH, suggesting its no implementation in these regions. We described characteristics, mortality, and neurological response before and after the use of TH in newborns with HIE within the EpicLatino Neonatal Network (ENN) and described the population of infants with HIE treated and not treated with TH.
Data were collected from 2015 to 2022 for patients with HIE. Mortality rates and Sarnat scores were compared before and after TH. The Wilcoxon Signed-Rank Test was used for comparisons.
In this observational study 518 neonates of our total population of 26 970, had HIE (1.92%) of whom 150 underwent TH. Ten out of 21 neonatal intensive care units (NICUs) provided TH. The Wilcoxon Signed Rank Test for 138 cases with complete data showed a significant difference.
The findings support the benefits of TH in HIE within this cohort. TH should not be withheld solely due to the economic status of the country. A strict patient selection and TH protocol are essential.
一项研究报告称,对于接受治疗性低温(TH)的低氧缺血性脑病(HIE)患者,在低收入和中等收入国家,治疗性低温并未降低18个月时的死亡率和残疾合并预后,这表明在这些地区不采用该疗法。我们描述了拉丁裔新生儿网络(ENN)中患有HIE的新生儿在使用TH前后的特征、死亡率和神经学反应,并描述了接受和未接受TH治疗的HIE婴儿群体。
收集了2015年至2022年期间HIE患者的数据。比较了TH前后的死亡率和萨纳特评分。采用Wilcoxon符号秩检验进行比较。
在这项观察性研究中,我们总共26970名新生儿中有518名患有HIE(1.92%),其中150名接受了TH治疗。21个新生儿重症监护病房(NICU)中有10个提供TH治疗。对138例有完整数据的病例进行的Wilcoxon符号秩检验显示有显著差异。
研究结果支持该队列中TH对HIE的益处。不应仅因国家的经济状况而不采用TH治疗。严格的患者选择和TH治疗方案至关重要。