Descripción de una cohorte de pacientes neonatos con diagnóstico de asfixia perinatal, tratados con hipotermia terapéutica. 2017

Abstract

Background

Hypoxic-ischaemic encephalopathy (HIE) is an acute neurological dysfunction, and affects 5/1000 term newborns worldwide. Mortality due to HIE ranges from 25% to 85%. The treatment of moderate and severe HIE is therapeutic hypothermia. The literature in Colombia is limited on the management of HIE.

Objective

The aim of this study is to describe the clinical, para-clinical, and demographic characteristics of patients with moderate to severe perinatal asphyxia treated using a therapeutic hypothermia protocol from January 2016 to July 2017.

Methodology

Observational study of a cohort. Descriptive statistics were used to present the characteristics of the patients, including calculating the frequency of fatal outcomes, and non-fatal outcomes, such as prolonged stay and prolonged intubation.

Results

In the total of 64 patients, mortality was 6.25% (n = 4). Just over half (54%) were male. The mean age on starting the protocol was 6 hours. The fatal outcomes were associated with: the age on starting the protocol, changes in coagulation, lactate, glycaemia, liver and cardiac enzymes (P=.01). The non-fatal outcome of prolonged stay was associated with: an abnormal base excess, renal function, and pH (P=.01).

Conclusion

The fatal outcome was associated with the age on starting the hypothermia protocol, alterations in liver and cardiac enzymes, coagulation times, glycaemia and increased lactate. The non-fatal outcome of prolonged intubation was associated with impaired renal function, pH, and abnormal base excess.