title: Therapeutic hypothermia for infants with hypoxic ischemic encephalopathy: A five years' single center experience in Kuwait.
abstract: OBJECTIVE
  We aimed to evaluate the effect of therapeutic hypothermia (TH) on brain MRI findings, neurological outcome, and mortality in patients with perinatal hypoxic ischemic encephalopathy (HIE) and compare between two modalities of TH: whole body cooling (WBC) and selective head cooling (SHC).
  
  
  METHODS
  Sixty-two inborn babies with HIE admitted to the NICU of a Kuwaiti teaching hospital between 2006 and 2013 were retrospectively reviewed. Patients were divided into two groups: group 1 (2006-2008, n = 30) never received hypothermia, and group 2 (2009-2013, n = 32) treated with hypothermia. Group 2 patients were chronologically divided into two subgroups: 2a, the SHC, (2009-2010, n = 15) and 2b, the WBC, (2011-2013, n = 17). Brain MRI taken 7-10 days after birth, neurological status and mortality at time of hospital discharge were evaluated.
  
  
  RESULTS
  Patients who received TH showed significantly fewer MRI hypoxic changes (P = 0.04) and had better neurological outcome. Their need for anticonvulsants diminished (P = 0.04). However, their need for inotropes and duration of mechanical ventilation were increased (P = 0.001 & 0.02 respectively). No significant difference in mortality was found between the two groups (P = 0.6). In regression analysis, only MRI hypoxic changes predicted the occurrence of neurological abnormalities (P = 0.001). No difference in brain MRI findings, neurological outcome and mortality was observed between subgroups 2a and 2b (P > 0.05).
  
  
  CONCLUSIONS
  TH improved the neurological outcome of HIE patients but had no effect on mortality. There was no difference between the two modalities of TH on patients' outcome.
authors.affiliation: Department of Neonatology, Farwaniya Hospital, Ministry of Health, Kuwait city, Kuwait.
authors.forename: A
authors.initials: A
authors.lastname: Elbahtiti
authors.affiliation: Department of Infection Control, Farwaniya Hospital, Ministry of Health, Kuwait city, Kuwait.|Department of Tropical Medicine and Hygiene, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
authors.forename: N Yehia
authors.initials: NY
authors.lastname: Aly
authors.affiliation: Department of Neonatology, Farwaniya Hospital, Ministry of Health, Kuwait city, Kuwait.
authors.forename: R
authors.initials: R
authors.lastname: Abo-Lila
authors.affiliation: Department of Neonatology, Farwaniya Hospital, Ministry of Health, Kuwait city, Kuwait.
authors.forename: R
authors.initials: R
authors.lastname: Al-Sawan
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000254:growth & development; D002657:Child Development / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D020925:Hypoxia-Ischemia, Brain / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D007730:Kuwait / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Hypothermia; Kuwait; encephalopathy