title: Evolution of encephalopathy during whole body hypothermia for neonatal hypoxic-ischemic encephalopathy.
abstract: OBJECTIVE
  To examine the predictive ability of stage of hypoxic-ischemic encephalopathy (HIE) for death or moderate/severe disability at 18 months among neonates undergoing hypothermia.
  
  
  METHODS
  Stage of encephalopathy was evaluated at <6 hours of age, during study intervention, and at discharge among 204 participants in the National Institute of Child Health and Human Development Neonatal Research Network Trial of whole body hypothermia for HIE. HIE was examined as a predictor of outcome by regression models.
  
  
  RESULTS
  Moderate and severe HIE occurred at <6 hours of age among 68% and 32% of 101 hypothermia group infants and 60% and 40% of 103 control group infants, respectively. At 24 and 48 hours of study intervention, infants in the hypothermia group had less severe HIE than infants in the control group. Persistence of severe HIE at 72 hours increased the risk of death or disability after controlling for treatment group. The discharge exam improved the predictive value of stage of HIE at <6 hours for death/disability.
  
  
  CONCLUSIONS
  On serial neurologic examinations, improvement in stage of HIE was associated with cooling. Persistence of severe HIE at 72 hours and an abnormal neurologic exam at discharge were associated with a greater risk of death or disability.
authors: Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
authors: Seetha
authors: S
authors: Shankaran
authors: Abbot R
authors: AR
authors: Laptook
authors: Jon E
authors: JE
authors: Tyson
authors: Richard A
authors: RA
authors: Ehrenkranz
authors: Carla M
authors: CM
authors: Bann
authors: Abhik
authors: A
authors: Das
authors: Rosemary D
authors: RD
authors: Higgins
authors: Rebecca
authors: R
authors: Bara
authors: Athina
authors: A
authors: Pappas
authors: Scott A
authors: SA
authors: McDonald
authors: Ronald N
authors: RN
authors: Goldberg
authors: Michele C
authors: MC
authors: Walsh
mesh_terms: D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000401:mortality / Q000628:therapy*; D007231:Infant, Newborn; D011379:Prognosis; D012044:Regression Analysis; D012720:Severity of Illness Index; D016896:Treatment Outcome