title: Outcome of infants with hypoxic ischemic encephalopathy treated with brain hypothermia.
abstract: OBJECTIVE
  The aim of this study was to determine perinatal factors associated with cerebral palsy (CP) in infants treated with brain hypothermia (BHT).
  
  
  METHODS
  We carried out a retrospective review of 23 infants with hypoxic ischemic encephalopathy in whom BHT was applied within 6 h after birth. Outcome regarding the presence or absence of CP was assessed at the age of 18 months. Oxygen extraction fraction (OEF) was measured before, during and after BHT at the jugular sinus.
  
  
  RESULTS
  Three infants died and 12 developed CP (poor outcome group). The remaining eight infants did not have CP at 18 months old (favorable outcome group). There were no differences in gestational age, birthweight, pH, base deficit, or lactate level between infants with favorable and poor outcomes. Infants with flat trace on electroencephalography on admission were less likely to have favorable outcome (0.0% [0/8] vs 53% [8/15], respectively, P = 0.02), while those with Apgar score at 10 min ≥5 (57% [8/14] vs 0.0% [0/9], P = 0.007) or ≥6 (70% [7/10] vs 7.7% [1/13], P = 0.002), OEF ≥ 13.3% during BHT (64% [7/11] vs 8.3% [1/12], P = 0.009), and OEF ≥ 18.5% after BHT (73% [8/11] vs 0.0% [0/12], P = 0.002) were more likely to have favorable outcome compared with those with counterpart characteristics.
  
  
  CONCLUSIONS
  Infants with an Apgar score at 10 min ≥5, activity on electroencephalography on admission, and higher OEF during and after BHT were likely to have a favorable outcome.
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tokuhisa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ibara
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maede
authors.forename: Chie
authors.initials: C
authors.lastname: Ishihara
authors.forename: Takako
authors.initials: T
authors.lastname: Matsui
mesh_terms: D001034:Apgar Score; D002547:Cerebral Palsy / Q000209:etiology*; D004569:Electroencephalography; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D007223:Infant; D066088:Infant Death; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood; D066087:Perinatal Death; D012189:Retrospective Studies
chemical_list: D010100:Oxygen
keywords: brain hypothermia; cerebral palsy; hypoxemia; hypoxic ischemic encephalopathy; neonatal encephalopathy