Electrocardiographic and echocardiographic changes during therapeutic hypothermia in encephalopathic infants with long-term adverse outcome

To assess the electrocardiography and echocardiography changes during therapeutic hypothermia and rewarming period in encephalopathic infants with long-term adverse neurological outcome. Prospective multicentre longitudinal study. We included 64 consecutive infants with moderate or severe hypoxic is...

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Bibliographic Details
Published in:Resuscitation 2018-09, Vol.130, p.99-104
Main Authors: Montaldo, Paolo, Cuccaro, Pasquale, Caredda, Elisabetta, Pugliese, Umberto, De Vivo, Massimiliano, Orbinato, Francesco, Magri, Daniela, Rojo, Silvana, Rosso, Roberto, Santantonio, Alfredo, Vitiello, Renato, Vacchiano, Teresa, Chello, Giovanni, Del Giudice, Emanuele Miraglia, Giliberti, Paolo
Format: Article
Language:English
Subjects:
Asphyxia Neonatorum - complications
Cardiac Output
Cerebrovascular Circulation
Echocardiography
Echocardiography - methods
Electrocardiography
Electrocardiography - methods
Female
Humans
Hypothermia, Induced - adverse effects
Hypothermia, Induced - methods
Hypoxia-Ischemia, Brain - diagnosis
Hypoxia-Ischemia, Brain - etiology
Hypoxia-Ischemia, Brain - mortality
Hypoxia-Ischemia, Brain - therapy
Hypoxic–ischaemic encephalopathy
Infant, Newborn
Long Term Adverse Effects - diagnosis
Longitudinal Studies
Male
Neonatal encephalopathy
Nervous System Diseases - diagnosis
Nervous System Diseases - epidemiology
Nervous System Diseases - etiology
Outcome Assessment (Health Care)
Prospective Studies
Rewarming - methods
Severity of Illness Index
Stroke Volume
Therapeutic hypothermia
Vena Cava, Superior - physiopathology
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Summary:To assess the electrocardiography and echocardiography changes during therapeutic hypothermia and rewarming period in encephalopathic infants with long-term adverse neurological outcome. Prospective multicentre longitudinal study. We included 64 consecutive infants with moderate or severe hypoxic ischaemic encephalopathy undergoing therapeutic hypothermia who had 18–24 month-outcome data. We analysed electrocardiography and heart rate changes before, during and after therapeutic hypothermia. Superior vena cava flow, left ventricular cardiac output and stroke volume were studied using echocardiography during and immediately after therapeutic hypothermia. An abnormal outcome was defined as death or moderate/severe disability at 18–24 months. Neonates with higher superior vena cava flow pre-rewarming had significantly higher odds of documented long-term adverse outcome when compared to newborns with good outcome (OR 1.57; 95%CI, 1.1–1.78; p = 0.01 after adjustment). QTc and RR intervals were significantly longer at 12, 24, 36 and 48 h in infants with good outcome compared with those with adverse outcome (p 
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2018.07.014