title: Effects of whole body therapeutic hypothermia on gastrointestinal morbidity and feeding tolerance in infants with hypoxic ischemic encephalopathy.
abstract: Objective. This retrospective cohort study evaluated the effects of whole body therapeutic hypothermia (WBTH) on gastrointestinal (GI) morbidity and feeding tolerance in infants with moderate-to-severe hypoxic ischemic encephalopathy (HIE). Study Design. Infants ≥ 35 weeks gestational age and ≥1800 grams birth weight with moderate-to-severe HIE treated from 2000 to 2012 were compared. 68 patients had documented strictly defined criteria for WBTH: 32 historical control patients did not receive WBTH (non-WBTH) and 36 cohort patients received WBTH. Result. More of the non-WBTH group infants never initiated enteral feeds (28% versus 6%; P = 0.02), never reached full enteral feeds (38% versus 6%, P = 0.002), and never reached full oral feeds (56% versus 19%, P = 0.002). Survival analyses demonstrated that the WBTH group reached full enteral feeds (median time: 11 versus 9 days; P = 0.02) and full oral feeds (median time: 19 versus 10 days; P = 0.01) sooner. The non-WBTH group had higher combined outcomes of death and gastric tube placement (47% versus 11%; P = 0.001) and death and gavage feeds at discharge (44% versus 11%; P = 0.005). Conclusion. WBTH may have beneficial effects on GI morbidity and feeding tolerance for infants with moderate-to-severe HIE.
authors.affiliation: Department of Neonatology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA ; School of Medicine, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Thornton
authors.affiliation: Research Development and Clinical Investigation, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: School of Medicine, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA ; Department of Gastroenterology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
authors.forename: Seth
authors.initials: S
authors.lastname: Septer
authors.affiliation: Department of Neonatology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA ; School of Medicine, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Petrikin