Hypoxic-ischemic encephalopathy: challenges in outcome and prediction.
The outcomes of hypoxic-ischemic encephalopathy vary between death and intact survival. The spectrum of long-term morbidity in survivors ranges from mild motor and cognitive deficits to cerebral palsy and severe cognitive deficits. Our literature review reinforces the notion that the spectrum of hypoxic-ischemic encephalopathy outcomes represents a continuum, which has important implications for the prediction of outcome and the indications for intervention. We summarize predictive criteria at 3 time points: the first 6 hours of life, 6-72 hours of life, and at hospital discharge. In this era of neuroprotection, predictive models that aid therapeutic decision making, including the withdrawal of support, need to be revised.
Department of Pediatrics, University of Toronto, Toronto, Canada. max.perlman@sympatico.ca
Max
M
Perlman
Prakesh S
PS
Shah
D001238:Asphyxia Neonatorum / Q000150:complications / Q000523:psychology; D003071:Cognition; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009043:Motor Activity; D010351:Patient Discharge; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors