Therapeutic hypothermia for neonatal encephalopathy with sepsis: a retrospective cohort study. Issue 1 (23rd March 2022)

• Record Type: Journal Article
• Authors: Sibbin, Kristina; Crawford, Tara M; Stark, Michael; Battin, Malcolm
• Other Names: author non-byline.; Morris Scott author non-byline.; Schmidt Peter author non-byline.; Korostenski Larissa author non-byline.; Sharp Mary author non-byline.; Resnick Steven author non-byline.; Thomas Rebecca author non-byline.; Gill Andy author non-byline.; Pillow Jane author non-byline.; Stack Jacqueline author non-byline.; Birch Pita author non-byline.; Nothdurft Karen author non-byline.; Casalaz Dan author non-byline.; Holberton Jim author non-byline.; Stewart Alice author non-byline.; Hunt Rod author non-byline.; Cooke Lucy author non-byline.; Downe Lyn author non-byline.; Stewart Michael author non-byline.; Berry Andrew author non-byline.; Hickey Leah author non-byline.; Morris Peter author non-byline.; Paoli Tony De author non-byline.; Spotswood Naomi author non-byline.; Bolisetty Srinivas author non-byline.; Lui Kei author non-byline.; Paradisis Mary author non-byline.; Greenhalgh Mark author non-byline.; Koorts Pieter author non-byline.; Kuschel Carl author non-byline.; Doyle Lex author non-byline.; Craven John author non-byline.; Collins Clare author non-byline.; Numa Andrew author non-byline.; Carlisle Hazel author non-byline.; Badawi Nadia author non-byline.; Popat Himanshu author non-byline.; Koh Guan author non-byline.; Davis Jonathan author non-byline.; Luig Melissa author non-byline.; Headley Bevan author non-byline.; Andersen Chad author non-byline.; Austin Nicola author non-byline.; Darlow Brian author non-byline.; Edmonds Liza author non-byline.; Bloomfield Guy author non-byline.; Buksh Mariam author non-byline.; Battin Malcolm author non-byline.; Boom Jutta van den author non-byline.; Gately Callum author non-byline.; Chambers Georgina author non-byline.; Rajadurai Victor Samuel author non-byline.; Barker David author non-byline.; Dhawan Anjali author non-byline.; Hammond Barbara author non-byline.; Merida Natalie author non-byline.; Harrison Denise author non-byline.; Battin M author non-byline.;
• Is Part Of: BMJ paediatrics open. Volume 6:Issue 1(2022)
• Publication Date: 2022-03-23
• Subjects: neonatology -- neurology; Pediatrics -- Periodicals; Children -- Health and hygiene -- Periodicals; 618.920005
• DOI: 10.1136/bmjpo-2022-001420
• Languages: English
• ISSNs: 2399-9772

Abstract

Abstract : Objective: Neonatal encephalopathy remains a major cause of infant mortality and neurodevelopmental impairment. Infection may exacerbate brain injury and mitigate the effect of therapeutic hypothermia (TH). Additionally, infants with sepsis treated with TH may be at increased risk of adverse effects. This study aimed to review the clinical characteristics and outcomes for infants with sepsis treated with TH. Design and setting: Retrospective cohort study of infants treated with TH within Australia and New Zealand. Patients: 1522 infants treated with TH, including 38 with culture-positive sepsis from 2014 to 2018. Intervention: Anonymised retrospective review of data from Australian and New Zealand Neonatal Network. Infants with culture-positive sepsis within 48 hours were compared with those without sepsis. Main outcome measures: Key outcomes include in-hospital mortality, intensive care support requirements and length of stay. Results: Overall the rate of mortality was similar between the groups (13% vs 13%). Infants with sepsis received a higher rate of mechanical ventilation (89% vs 70%, p=0.01), high-frequency oscillatory ventilation (32% vs 13%, p=0.003) and inhaled nitric oxide for persistent pulmonary hypertension (38% vs 16%, p<0.001). Additionally, the sepsis group had a longer length of stay (20 vs 11 days, p<0.001). Conclusion: Infants with sepsis treated with TH required significantly more respiratory support and had a longer length of stay. Although this may suggest a more severe illness the rate of mortality was similar. Further research is warranted to review the neurodevelopmental outcomes for these infants.