الفهرس 
Hypoxic Ischemic Encephalopathy (HIE)Only 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Therapeutic hypothermia (TH) is a standard of care for neonatal hypoxic ischemic encephalopathy (HIE) in developed countries. Most data come from high income countries (HIC). Recently, experts suggest that the safety and efficacy data on cooling from HIC should not be extrapolated to low and middle income countries (LMIC). Although a number of pilot studies have been reported from LMIC, none of these studies had statistical power to detect significant effects of hypothermia after stratification by country income.
Aim of the Work: Evaluate the practice of TH as a treatment for neonates with HIE admitted to NICUs of Ain Shams University Hospitals from 1/2016 to 12/2020 in a retrospective manner.
Patients and Methods: All HIE babies who were treated with TH were included. Retrospectively, patients’ medical records of included babies were reviewed and analyzed. Survived neonates were approached by telephone interview regarding parental views on their neurodevelopment and were offered a formal neurodevelopmental assessment for their babies using Bayley Scale III.
Results: A total of 37 neonates (17 survived and 20 died) were included: 2 mild HIE (survived), 13 severe HIE (all died) and 22 moderate HIE (15 survived and 7 died) (mortality 54.1%). The higher the degree of encephalopathy is associated with decreased survival rate and has highly statistical significance with P-value < 0.005. The most common causes of death are pulmonary hemorrhage (24.3%) and shock (24.3%). Of the 17 survivors, 6 patients couldn’t be reached while 9 patients had satisfactory neurodevelopmental progression as per their parents’ views while 2 patients had poor outcome. Bayley III scale was done for only 3 babies because the rest of parents refused to comeback to do this scale for their babies. The ages of the 3 babies when Bayley-III done were: 13 months old, 13.5 months old & 14.5 months old. All had normal cognitive and language development. Two of them had normal motor development while one patient had mild to moderate motor delay.
Conclusion: TH might not improve outcome of sever HIE but of great value on outcome of moderate HIE. Prospective future studies are recommended to assess the role of TH as a neuroprotective agent for neonates with HIE in a low resource setting.