Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy

Seetha Shankaran, Patrick D. Barnes, Susan R. Hintz, Abbott R. Laptook, Kristin M. Zaterka-Baxter, Scott A. McDonald, Richard A. Ehrenkranz, Michele C. Walsh, Jon E. Tyson, Edward F. Donovan, Ronald N. Goldberg, Rebecca Bara, Abhik Das, Neil N. Finer, Pablo J. Sanchez, Brenda B. Poindexter, Krisa P. Van Meurs, Waldemar A. Carlo, Barbara J. Stoll, Shahnaz DuaraRonnie Guillet, Rosemary D. Higgins

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Objective: The objective of our study was to examine the relationship between brain injury and outcome following neonatal hypoxic-ischaemic encephalopathy treated with hypothermia. Design and patients: Neonatal MRI scans were evaluated in the National Institute of Child Health and Human Development (NICHD) randomised controlled trial of whole-body hypothermia and each infant was categorised based upon the pattern of brain injury on the MRI fi ndings. Brain injury patterns were assessed as a marker of death or disability at 18-22 months of age. Results: Scans were obtained on 136 of 208 trial participants (65%); 73 in the hypothermia and 63 in the control group. Normal scans were noted in 38 of 73 infants (52%) in the hypothermia group and 22 of 63 infants (35%) in the control group. Infants in the hypothermia group had fewer areas of infarction (12%) compared to infants in the control group (22%). Fifty-one of the 136 infants died or had moderate or severe disability at 18 months. The brain injury pattern correlated with outcome of death or disability and with disability among survivors. Each point increase in the severity of the pattern of brain injury was independently associated with a twofold increase in the odds of death or disability. Conclusions: Fewer areas of infarction and a trend towards more normal scans were noted in brain MRI following whole-body hypothermia. Presence of the NICHD pattern of brain injury is a marker of death or moderate or severe disability at 18-22 months following hypothermia for neonatal encephalopathy.

Original languageEnglish
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Volume97
Issue number6
DOIs
StatePublished - Nov 2012

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Brain Hypoxia-Ischemia
Hypothermia
Brain Injuries
National Institute of Child Health and Human Development (U.S.)
Control Groups
Infarction
Brain Diseases
Survivors
Randomized Controlled Trials
Magnetic Resonance Imaging
Brain

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Shankaran, S., Barnes, P. D., Hintz, S. R., Laptook, A. R., Zaterka-Baxter, K. M., McDonald, S. A., ... Higgins, R. D. (2012). Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy. Archives of Disease in Childhood: Fetal and Neonatal Edition, 97(6). https://doi.org/10.1136/archdischild-2011-301524

Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy. / Shankaran, Seetha; Barnes, Patrick D.; Hintz, Susan R.; Laptook, Abbott R.; Zaterka-Baxter, Kristin M.; McDonald, Scott A.; Ehrenkranz, Richard A.; Walsh, Michele C.; Tyson, Jon E.; Donovan, Edward F.; Goldberg, Ronald N.; Bara, Rebecca; Das, Abhik; Finer, Neil N.; Sanchez, Pablo J.; Poindexter, Brenda B.; Van Meurs, Krisa P.; Carlo, Waldemar A.; Stoll, Barbara J.; Duara, Shahnaz; Guillet, Ronnie; Higgins, Rosemary D.

In: Archives of Disease in Childhood: Fetal and Neonatal Edition, Vol. 97, No. 6, 11.2012.

Research output: Contribution to journalArticle

Shankaran, S, Barnes, PD, Hintz, SR, Laptook, AR, Zaterka-Baxter, KM, McDonald, SA, Ehrenkranz, RA, Walsh, MC, Tyson, JE, Donovan, EF, Goldberg, RN, Bara, R, Das, A, Finer, NN, Sanchez, PJ, Poindexter, BB, Van Meurs, KP, Carlo, WA, Stoll, BJ, Duara, S, Guillet, R & Higgins, RD 2012, 'Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy', Archives of Disease in Childhood: Fetal and Neonatal Edition, vol. 97, no. 6. https://doi.org/10.1136/archdischild-2011-301524
Shankaran, Seetha ; Barnes, Patrick D. ; Hintz, Susan R. ; Laptook, Abbott R. ; Zaterka-Baxter, Kristin M. ; McDonald, Scott A. ; Ehrenkranz, Richard A. ; Walsh, Michele C. ; Tyson, Jon E. ; Donovan, Edward F. ; Goldberg, Ronald N. ; Bara, Rebecca ; Das, Abhik ; Finer, Neil N. ; Sanchez, Pablo J. ; Poindexter, Brenda B. ; Van Meurs, Krisa P. ; Carlo, Waldemar A. ; Stoll, Barbara J. ; Duara, Shahnaz ; Guillet, Ronnie ; Higgins, Rosemary D. / Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy. In: Archives of Disease in Childhood: Fetal and Neonatal Edition. 2012 ; Vol. 97, No. 6.
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AU - Shankaran, Seetha

AU - Barnes, Patrick D.

AU - Hintz, Susan R.

AU - Laptook, Abbott R.

AU - Zaterka-Baxter, Kristin M.

AU - McDonald, Scott A.

AU - Ehrenkranz, Richard A.

AU - Walsh, Michele C.

AU - Tyson, Jon E.

AU - Donovan, Edward F.

AU - Goldberg, Ronald N.

AU - Bara, Rebecca

AU - Das, Abhik

AU - Finer, Neil N.

AU - Sanchez, Pablo J.

AU - Poindexter, Brenda B.

AU - Van Meurs, Krisa P.

AU - Carlo, Waldemar A.

AU - Stoll, Barbara J.

AU - Duara, Shahnaz

AU - Guillet, Ronnie

AU - Higgins, Rosemary D.

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N2 - Objective: The objective of our study was to examine the relationship between brain injury and outcome following neonatal hypoxic-ischaemic encephalopathy treated with hypothermia. Design and patients: Neonatal MRI scans were evaluated in the National Institute of Child Health and Human Development (NICHD) randomised controlled trial of whole-body hypothermia and each infant was categorised based upon the pattern of brain injury on the MRI fi ndings. Brain injury patterns were assessed as a marker of death or disability at 18-22 months of age. Results: Scans were obtained on 136 of 208 trial participants (65%); 73 in the hypothermia and 63 in the control group. Normal scans were noted in 38 of 73 infants (52%) in the hypothermia group and 22 of 63 infants (35%) in the control group. Infants in the hypothermia group had fewer areas of infarction (12%) compared to infants in the control group (22%). Fifty-one of the 136 infants died or had moderate or severe disability at 18 months. The brain injury pattern correlated with outcome of death or disability and with disability among survivors. Each point increase in the severity of the pattern of brain injury was independently associated with a twofold increase in the odds of death or disability. Conclusions: Fewer areas of infarction and a trend towards more normal scans were noted in brain MRI following whole-body hypothermia. Presence of the NICHD pattern of brain injury is a marker of death or moderate or severe disability at 18-22 months following hypothermia for neonatal encephalopathy.

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