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Original Paper

Hypothermia Makes Cerebral Resistance Index a Poor Prognostic Tool in Encephalopathic Newborns

Skranes J.H.a, c · Elstad M.b · Thoresen M.b, d · Cowan F.M.d · Stiris T.a, c · Fugelseth D.a

Author affiliations

aInstitute of Clinical Medicine, Faculty of Medicine, and bDepartment of Physiology, Institute of Basic Medical Sciences, University of Oslo, and cDepartment of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway; dNeonatal Neuroscience, School of Medical Sciences, University of Bristol, Bristol, UK

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Neonatology 2014;106:17-23

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: October 23, 2013
Accepted: December 27, 2013
Published online: March 25, 2014
Issue release date: June 2014

Number of Print Pages: 7
Number of Figures: 4
Number of Tables: 2

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

Background: Severe neonatal encephalopathy (NE) of hypoxic-ischaemic origin may cause death or life-long disability. Acute encephalopathy may also affect cerebrovascular control. Pourcelot's cerebrovascular resistance index (RI) ≤0.55 was predictive of poor outcome in normothermic NE infants. Recent studies have questioned its predictive power during therapeutic hypothermia (HT). Objective: To assess the predictive power of RI during HT and after rewarming. Methods: 45 infants with NE treated with HT for 72 h had their RI calculated during early (median 11 h) and late (median 62 h) cooling and after rewarming (median 89 h). Poor outcome was defined as death or abnormalities on day 10 magnetic resonance imaging shown to predict severe neuromotor disability. Results: RI ≤0.55 during cooling did not differentiate between good and poor outcome (late cooling, p = 0.08), but was powerful after rewarming (p = 0.004). RI ≤0.55 predicted true poor outcome in 43% (95% confidence interval (CI): 12, 80) during late cooling and in 100% (95% CI: 31, 100) after rewarming. RI >0.55 predicted good outcome in 86% (95% CI: 69, 95) during late cooling and in 89% (95% CI: 74, 96) after rewarming. Conclusions: Low RI is not predictive of poor outcome during HT in NE infants, but regains the predictive power seen in normothermic infants after rewarming.

© 2014 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: October 23, 2013
Accepted: December 27, 2013
Published online: March 25, 2014
Issue release date: June 2014

Number of Print Pages: 7
Number of Figures: 4
Number of Tables: 2

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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