[Brain hypothermia therapy for newborns with severe birth asphyxia: an experience from a single neonatal intensive care unit].
The object of this study was to determine the efficacy and safety of brain hypothermia therapy (BHT) for neonates with severe birth asphyxia in our neonatal intensive care unit (NICU). We retrospectively reviewed medical records to analyze the prognosis and the factors affecting the prognosis of 21 patients who underwent BHT at the NICU between 2001 and 2007. The prognosis of those 21 patients at the time of discharge from the NICU was as follows: good-11 patients (52.4%); disability-5 patients (23.8%); and death-5 patients (23.8%). The ten poor prognosis patients (disability: 5, death: 5) had a shorter gestational period, a lower Apgar score, and a significantly higher blood lactate level in comparison with good-prognosis newborns. In particular, a gestational period of less than 34 weeks (3 patients) and a blood lactate level of at least 200 mg/dl (6 out of 7 patients) are considered to be factors for a poor prognosis. In addition, intraventricular hemorrhage was recorded in 7 patients of the 10 poor-prognosis patients and 4 of those patients developed acute renal failure during BHT. Consequently, these disorders are considered to worsen the prognosis. This study supports the efficacy and safety of BHT for neonates with severe birth asphyxia. On the other hand, BHT for the above mentioned types of high-risk patients still requires further consideration for the adoption and methods of BHT.
Araki
Shunsuke
S
Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Takahashi
Daijiro
D
Matsui
Miyu
M
Saito
Reiko
R
Morita
Hiromi
H
Ishii
Masahiro
M
Senjyu
Ayako
A
Morishita
Takahiro
T
Takano
Shiho
S
Chiba
Soromon
S
Mori
Jiro
J
Kubo
Kazuyasu
K
Sato
Hiroshi
H
Kawakami
Akihiro
A
Shimono
Masayuki
M
Shirahata
Akira
A
Kusuhara
Koichi
K
D001238:Asphyxia Neonatorum / Q000097:blood / Q000628:therapy*; D001921:Brain; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007564:Japan / Q000453:epidemiology; D019344:Lactic Acid / Q000097:blood; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D012720:Severity of Illness Index
D019344:Lactic Acid