Long Term Outcome after Therapeutic Hypothermia in Neonatal Hypoxic-ischemic Encephalopathy

Outcome after Therapeutic Hypothermia in Neonatal Hypoxic-ischemic Encephalopathy Purpose: Therapeutic hypothermia is known to improve neurologic outcomes in hypoxic-ischemic encephalopathy(HIE) newborns.To the best of our knowledge, no report exists on the long term neurologic outcomes of HIE newborns who received therapeutic hypothermia in Korea, and we decided to conduct a study to evaluate these outcomes.Methods: A chart review was performed for 154 patients who were diagnosed with HIE at the neonatal intensive care unit of Seoul St. Mary's hospital from April 2012 to July 2014.We compared newborns who have treated therapeutic hypothermia with newborns who have not due to more than 6 hours after birth.Outcomes were verified with magnetic resonance imaging (MRI), electroencephalogram (EEG), and neurologic assessment using the Korean Ages and Stages Questionnaires (K-ASQ), Infant Toddler checklist (ITC) at the outpatient clinic.Results: Among 154 newborns, 117 underwent the 18 month-neurologic examination.Among these newborns, 56 received therapeutic hypothermia treatment and 61 did not.At 18 month neurological examination, developmental delay was observed in six of 56 newborns with therapeutic hypothermia and seven of 22 newborns without therapeutic hypothermia (P=0.04).Conclusion: If therapeutic hypothermia is accompanied with early diagnosis, active neurologic status monitoring, and hemodynamic status monitoring, therapeutic hypothermia may be helpful for the prognosis of HIE in newborns.