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Observational Study
. 2022 Jul;42(7):907-913.
doi: 10.1038/s41372-022-01413-6. Epub 2022 May 16.

Association between multi-organ dysfunction and adverse outcome in infants with hypoxic ischemic encephalopathy

Elisabeth S Yan  1 , Valerie Y Chock  1 , Sonia Lomeli Bonifacio  1 , Alex Dahlen  2 , Carolina V Guimaraes  3 , Gabriel Altit  4 , Shazia Bhombal  1 , Krisa Van Meurs  5
Affiliations
Observational Study

Association between multi-organ dysfunction and adverse outcome in infants with hypoxic ischemic encephalopathy

Elisabeth S Yan et al. J Perinatol. 2022 Jul.

Abstract

Objective: To evaluate multi-organ dysfunction (MOD) in newborns treated with therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE), and to compare MOD in those with normal/mild magnetic resonance imaging (MRI) findings to those with moderate to severe MRI findings or death.

Study design: Retrospective single-center observational study of infants treated with TH. A total of 16 parameters across 7 organ systems were analyzed. Primary outcome was death or moderate to severe brain injury on MRI.

Result: Of 157 infants treated with TH, 77% had ≥2 organ systems with dysfunction. The number of organ systems with dysfunction was strongly associated with death or moderate-to-severe brain injury (p < 0.0001). Hematologic (68%) and hepatic (65%) dysfunction were most common. Neurologic and renal dysfunction were most strongly associated with the primary outcome (OR 13.5 [6.1-29.8] and 11.2 [4.1-30.3], respectively), while pulmonary hypertension was not.

Conclusion: MOD is prevalent in infants undergoing TH for HIE, and the association between MOD and adverse outcomes may impact clinical care and counseling.

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References

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