血管内治疗性低温对中重度缺氧缺血性脑病的疗效
Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic-Ischemic Encephalopathy.
作者信息
Kurimoto Tomonori, Tokuhisa Takuya, Hayasaka Itaru, Yamamoto Tsuyoshi, Hirakawa Eiji, Ohashi Hiroshi, Kibe Masaya, Yara Asataro, Maeda Takatsugu, Kamitomo Masato, Ibara Satoshi
机构信息
Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, Japan.
Department of Pediatrics, Social Medical Corporation Bokoi, Nikko Memorial Hospital, Muroran 051-8512, Japan.
出版信息
Children (Basel). 2025 May 6;12(5):605. doi: 10.3390/children12050605.
BACKGROUND/OBJECTIVES: Hypoxic-ischemic encephalopathy (HIE), affecting 1.3-1.7/1000 live births, is treated with conventional therapeutic hypothermia (TH) but carries significant mortality and neurological impairment. Here, we compared intravascular cooling with extracorporeal membrane oxygenation (ECMO) and conventional TH in neonates with moderate to severe HIE.
METHODS
We retrospectively analyzed single-center neonates born in 2000-2022. Neonates with a 10 min Apgar score ≤ 3 or umbilical artery pH ≤ 6.7, along with persistent pulmonary hypertension of the newborn and an oxygenation index of ≥25 to <40, were divided into ECMO ( = 17) and conventional TH ( = 18) groups and administered the Kyoto Scale of Psychological Development at 18 months.
RESULTS
Neonatal and maternal characteristics were similar between the groups. A significantly higher proportion of the ECMO group (70.6% vs. 33.3%) achieved a developmental quotient ≥ 70.
CONCLUSIONS
Intravascular cooling with ECMO may improve the neurodevelopmental outcomes of neonates with HIE, severe acidosis, and low Apgar scores.
背景/目的：缺氧缺血性脑病（HIE）影响1.3 - 1.7/1000活产儿，采用传统治疗性低温（TH）进行治疗，但仍有显著的死亡率和神经功能障碍。在此，我们比较了血管内冷却联合体外膜肺氧合（ECMO）与传统TH对中重度HIE新生儿的治疗效果。
方法
我们回顾性分析了2000年至2022年在单中心出生的新生儿。将出生后10分钟阿氏评分≤3或脐动脉pH≤6.7，同时伴有新生儿持续性肺动脉高压且氧合指数≥25至<40的新生儿分为ECMO组（n = 17）和传统TH组（n = 18），并在18个月时对其进行京都心理发育量表评估。
结果
两组新生儿及母亲的特征相似。ECMO组达到发育商≥70的比例显著更高（70.6%对33.3%）。
结论
ECMO血管内冷却可能改善患有HIE、严重酸中毒和低阿氏评分的新生儿的神经发育结局。
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