An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy.

Autor: Okulu E; Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye., Hirfanoglu IM; Gazi University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye., Satar M; Cukurova University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adana, Türkiye., Erdeve O; Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye., Koc E; Gazi University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye., Ozlu F; Cukurova University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adana, Türkiye.; Department of Neonatology, Seyhan State Hospital, Adana, Türkiye., Gokce M; Department of Neonatology, Seyhan State Hospital, Adana, Türkiye., Armangil D; Department of Pediatrics, Neonatal Intensive Care Unit, Koru Hospital, Ankara, Türkiye., Tunc G; Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Sivas, Türkiye., Demirel N; Yildirim Beyazit University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye.; Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Türkiye., Unal S; Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Türkiye., Ozdemir R; Inonu University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Malatya, Türkiye., Deveci MF; Inonu University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Malatya, Türkiye., Akar M; Department of Neonatology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir Türkiye., Demirel MK; Department of Neonatology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir Türkiye., Çetinkaya M; Department of Neonatology, University of Health Sciences, Basaksehir Çam and Sakura City Hospital, Istanbul, Türkiye., Buker HSC; Department of Neonatology, University of Health Sciences, Basaksehir Çam and Sakura City Hospital, Istanbul, Türkiye., Karagöl BS; Gulhane Faculty of Medicine, Department of Pediatrics, Division of Neonatology, University of Health Sciences, Ankara, Türkiye., Yaprak D; Gulhane Faculty of Medicine, Department of Pediatrics, Division of Neonatology, University of Health Sciences, Ankara, Türkiye., Akcan AB; Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Aydin, Türkiye., Anik A; Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Aydin, Türkiye., Narter F; Department of Neonatology, University of Health Sciences, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Türkiye., Arayici S; Department of Neonatology, Eskisehir State Hospital, Eskisehir, Türkiye., Yildirim E; Department of Neonatology, Eskisehir State Hospital, Eskisehir, Türkiye., Akin IM; Department of Neonatology, University of Health Sciences, Umraniye Training and Research Hospital Istanbul, Istanbul, Türkiye., Sahin O; Department of Neonatology, University of Health Sciences, Umraniye Training and Research Hospital Istanbul, Istanbul, Türkiye., Ozdemir OEB; Medeniyet University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye., Ovali F; Medeniyet University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye., Akin MA; Ondokuz Mayis University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Samsun, Türkiye., Celik Y; Mersin University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Mersin, Türkiye., Orman A; Mersin University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Mersin, Türkiye., Uslu S; Department of Neonatology, University of Health Sciences, Sisli Etfal Hamidiye Training and Research Hospital, Istanbul, Türkiye., Ozkan H; Uludag University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Bursa, Türkiye., Koksal N; Uludag University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Bursa, Türkiye., Tastekin A; Medipol University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye., Gunduz M; Medipol University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye., Arisoy AE; Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Türkiye., Gurpinar R; Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kocaeli, Türkiye., Ors R; Department of Pediatrics, Neonatal Intensive Care Unit, Ozel Medova Hospital, Konya, Türkiye., Altunhan H; Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Konya, Türkiye., Kececi R; Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Konya, Türkiye., Yildizdas HY; Cukurova University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Adana, Türkiye., Terek D; Ege University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir, Türkiye., Ates M; Ege University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir, Türkiye., Kader S; Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Trabzon, Türkiye., Mutlu M; Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Trabzon, Türkiye., Çelik K; Akdeniz University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Antalya, Türkiye., Yucesoy E; Harran University Faculty of Medicine, Department of Pediatrics Division of Neonatology, Sanliurfa, Türkiye., Mert MK; Department of Neonatology, University of Health Sciences, Adana, Türkiye., Gulasi S; Department of Neonatology, University of Health Sciences, Adana, Türkiye., Kucuktasci K; Adana City Training and Research Hospital, Department of Pediatrics, Neonatal Intensive Care Unit, Ozel Saglik Hospital, Denizli, Türkiye., Arman D; Department of Neonatology, Istanbul Training and Research Hospital, Istanbul, Türkiye., Hekimoglu B; Department of Neonatology, University of Health Sciences, Kanuni Training and Research Hospital, Trabzon, Türkiye., Gultekin ND; Department of Neonatology, Van Regional Training and Research Hospital, Van, Türkiye., Celik HT; Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye., Kahvecioglu D; Department of Neonatology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Türkiye., Akyildiz C; Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Izmir, Türkiye., Taşkın E; Fırat University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Elazıg, Türkiye., Ciftdemir NA; Trakya University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Edirne, Türkiye., Uygun SS; Necmettin Erbakan University Selcuk Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Konya, Türkiye., Kaya TB; Osmangazi University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Eskisehir, Türkiye., Akdag A; Department of Neonatology, University of Health Sciences, Yuksek Ihtisas Teaching Hospital, Bursa, Türkiye., Yilmaz A; Cerrahpasa University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Türkiye.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Dec 14; Vol. 18 (12), pp. e0295759. Date of Electronic Publication: 2023 Dec 14 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0295759
Abstrakt: Background: Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants.
Methods: The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022.
Results: The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p<0.001). No significant difference in mortality and abnormal MRI results was found according to the time of TH initiation (<3 h, 3-6 h and >6 h) (p>0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007).
Conclusion: The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether <3 or 3-6 h, did not result in lower occurrences of brain lesions on MRI or mortality. An increasing number of infants with mild HIE and late preterm infants with HIE are receiving TH; however, the indications for TH require further clarification. Longer follow-up studies are necessary for this vulnerable population.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Okulu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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