294 Successful Implementation of Hypothermia Treatment in Sweden - Outcome at 24 Months of Age in Hypothermia-Treated Infants with Hie. (October 2012)

• Record Type: Journal Article
• Authors: Grossmann, K Robertson; Ragnö, J; Vollmer, B; Blennow, M; Hallberg, B
• Is Part Of: Archives of disease in childhood. Volume 97(2012)Supplement 2
• Page Start: A86
• Page End: A86
• Publication Date: 2012-10
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2012-302724.0294
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Hypoxic-ischemic encephalopathy (HIE) is associated with a high risk for subsequent neurological sequele. This study evaluates the implementation of HT in Sweden. Are national guidelines adhered to? Are outcome results comparable to those from previous controlled trials? Methods: Between 2007–2009, HT was available at 8 Swedish hospitals. Outcome data regarding all 187 infants who received HT during this period was collected and scored (normal/"motor delay"/cerebral palsy (CP)/dead). Local guidelines for clinical follow-up differing from the national guidelines were also reviewed. Results: Outcome data was available in 87% of treated infants. 13% had died, 74% had been assessed between 15–36 months of age with a neurological exam and using scales for grading of severity of CP, such as the Gross Motor Classification System. 35% had been assessed according to national guidelines using Bayley III. Conclusions: HT has been successfully implemented; however structured, comprehensive assessments according to national guidelines are not always carried out. In particular, only about 1/3 of infants undergo a psychometric developmental assessment. The incidence of severe adverse neuromotor outcome is comparable to what was to be expected from earlier RCTs, showing that HT has a significant positive effect also outside of controlled trials.