Outcome of Neonates Given Therapeutic Hypothermia For Severe Birth Asphyxia

Hafsa  Asad; Asma  Razzaq; Umair  Ahmed; Misbah  Fakih; Rabia  Khalid; Sana  Jabeen

doi:10.51253/pafmj.v75iSUPPL-6.8672

Authors

Hafsa Asad Department of Paeds, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Asma Razzaq Department of Paeds, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Umair Ahmed Department of Surgery,Faisal hospital ,Karachi Pakistan
Misbah Fakih Department of Paeds, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Rabia Khalid Department of Paeds, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Sana Jabeen Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-6.8672

Keywords:

Encephalopathy, Hypothermia, Neonate

Abstract

Objective: To evaluate outcomes in neonates afflicted with severe birth asphyxia provided with therapeutic hypothermia.

Study Design: Comparative prospective study.

Place and Duration of Study: Military Hospital Rawalpindi from Jan 2018 to Dec 2018.

Methodology: 124 birth asphyxiated neonates were enrolled with further segregation in Group A (Cases) and Group B (Controls). Group A neonates were instituted therapeutic hypothermia with specialized equipment (Techotherm Machine). Complications (such as hemorrhage, infections, hepatic injury, and mortality) were noted and subsequently neurological examinations at six, and twelve months were done to look for hypoxic-ischemic encephalopathic symptoms in both groups.

Results: 124 birth asphyxiated neonates were admitted, and procedure was initiated at 3.45 hour approx. Rectal temperature was recorded to be 33.41 ± 0.5°C. It was found that neonates in Group A have lesser hypoxic-ischemic encephalopathic and other complications than neonates in Group B i-e thrombocytopenia (A: 16(26.3%), B:23(36.8%), hepatic injury (A: 23(36.8%), B: 35(57%) and acidosis (A: 13(21%), B: 23(36.8%). Pulmonary hypertension 19(31%) which was more prevalent in Group B and bradycardia 56(90%) was incessant in Group A due to hypothermia. A follow up neurological exam at six and twelve was observed to be normal in 35(56%)of patients in group A whereas only 25(41%) showed a normal response in group B.

Conclusion: Therapeutic hypothermia can succor as a paradigmatic treatment modality for asphyxiated neonates, if instituted well in time and appropriately. Based on available resources and protocols, guidelines can be established regarding active or passive cooling.

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