title: Outcome After Therapeutic Hypothermia in Term Neonates With Encephalopathy and a Syndromic Diagnosis.
abstract: The large randomized, controlled trials of therapeutic hypothermia for hypoxic-ischemic encephalopathy excluded neonates with congenital disorders. The objective of this study was to report our experience using hypothermia in neonates with signs of hypoxic-ischemic encephalopathy and a syndromic disorder or brain anomaly. Subjects were identified from a database of neonates admitted to the Neuro-Intensive Care Nursery at University of California, San Francisco. Of 169 patients fulfilling criteria for hypothermia, 8 (5%) had a syndromic disorder and were cooled per guidelines for nonsyndromic neonates. Perinatal characteristics of infants with and without syndromic disorder were not significantly different. Overall outcome was poor: 38% had evidence of acute hypoxic-ischemic injury, 3 subjects died, and 2 survivors had low developmental quotient (ie, 25). The risk versus benefit of therapeutic hypothermia for hypoxic-ischemic encephalopathy among neonates with congenital brain malformations or syndromic diagnoses is uncertain.
authors.affiliation: Department of Child and Adolescent Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Mrelashvili
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA.
authors.forename: Sonia L
authors.initials: SL
authors.lastname: Bonifacio
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Rogers
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Shimotake
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA Department of Neurology, University of California, San Francisco, CA, USA hannah.glass@ucsf.edu.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Glass
mesh_terms: D001921:Brain / Q000002:abnormalities; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D020925:Hypoxia-Ischemia, Brain / Q000453:epidemiology / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D009421:Nervous System Malformations / Q000453:epidemiology / Q000628:therapy*; D012306:Risk; D013577:Syndrome; D016896:Treatment Outcome
keywords: congenital abnormalities; cooling; hypoxic-ischemic encephalopathy; infants with syndromes; neonatal encephalopathy; neurocritical care; therapeutic hypothermia