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. 2022 Mar;42(3):348-353.
doi: 10.1038/s41372-021-01302-4. Epub 2022 Jan 8.

Blanket temperature during therapeutic hypothermia and outcomes in hypoxic ischemic encephalopathy

John Flibotte  1   2 , Abbot R Laptook  3 , Seetha Shankaran  4 , Scott A McDonald  5 , Mariana C Baserga  6 , Edward F Bell  7 , C Michael Cotten  8 , Abhik Das  9 , Sara B DeMauro  1   2 , Tara L DuPont  6 , Eric C Eichenwald  1   2 , Roy Heyne  10 , Erik A Jensen  1   2 , Krisa P Van Meurs  11 , Kevin Dysart  12 ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Collaborators, Affiliations

Blanket temperature during therapeutic hypothermia and outcomes in hypoxic ischemic encephalopathy

John Flibotte et al. J Perinatol. 2022 Mar.

Abstract

Objective: Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE).

Study design: Retrospective cohort study of 181 infants with HIE who received TH in two randomized trials within the Neonatal Research Network. We defined summative blanket temperature constructs and evaluated for association with a primary composite outcome of death or moderate/ severe disability at 18-22 months.

Results: Each 0.5 °C above 33.5 °C in the mean of the highest quartile blanket temperature was associated with a 52% increase in the adjusted odds of death/ disability (aOR 1.52, 95% CI 1.09-2.11). Having >8 consecutive blanket temperatures above 33.5 °C rendered an aOR of death/disability of 5.04 in the first 24 h (95% CI 1.54-16.6) and 6.92 in the first 48 h (95% CI 2.20-21.8) of TH.

Conclusions: Higher blanket temperature during TH may be an early, clinically useful biomarker of HIE outcome.

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Conflict of interest statement

Competing interests:

For the Induced Hypothermia trial:

Dr. Cotten reports having served on the data and safety monitoring board for the Inhibitex phase 3 study of Vernonate for the prevention of infections in preterm infants.

Figures

Figure 1:
Figure 1:. Cohort assembly
Assembled cohort of patients from the Induced Hypothermia (IH) and Longer, Deeper Cooling (OC) trials.
Figure 2:
Figure 2:. Percent of infants with death or disability stratified by consecutive blanket temperatures >33.5°C
Death or moderate/ severe disability stratified by number of consecutive blanket temperatures above 33.5°C in the first 24 hours of TH (solid) and the first 48 hours of TH (checkered). Trends for association between greater number of consecutive blanket temperatures and increased death or disability were significant for both the first 24h of TH (p=0.005) as well as the first 48h of TH (p=0.0004) by Cochran-Armitage trend tests.
See this image and copyright information in PMC

References

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