EC Paediatrics

Background: Perinatal Hypoxic Ischemic Encephalopathy (HIE) is an important cause of Neonatal Encephalopathy, and contributes to both infant mortality and long term disability in children. Therapeutic hypothermia (TH) has transformed clinicians treatment approaches and improved clinical outcomes.

Objective: We studied the Factors affecting short term outcome of therapeutic hypothermia in Neonatal Hypoxic Ischemic Encephalopathy and factors contributing to these morbidity and mortality in these neonates in Neonatal Intensive Care Unit (NICU) at tertiary care hospital.

Method: It is a hospital-based, cross-sectional study conducted over 18 months. A total of 90 neonates were included in this study which satisfy the inclusion criteria. Before starting therapeutic hypothermia, clinical and outcome parameters and existence of co-morbidities was recorded, according to a predesigned proforma.

Results: Out of 90 babies, 82 (91.1%) were born by vaginal route, 8 (8.8%) were of lower segment cesarean section. More of babies who delivered by vaginal route undergone therapeutic hypothermia, 67 (74.4%) babies required bag and mask ventilation, 21 (23.3%) babies required endotracheal intubation and 2 (2.2%) babies required drugs in the delivery room for resuscitation. 60 (66.6%) babies had moderate encephalopathy and 30 (33.3%) babies had severe encephalopathy. Mean gestational age was 38.3 weeks in our study, mean birth weight in our study was 2.79 kilograms, mean temperature at admission was 34.48°C in our study, mean depth of cooling of 33.53°C in our study.

Conclusion: Our study shows that hypothermia treatment is feasible in resource limited settings and outcome of asphyxiated neonates can be improved.

Keywords: Neonatal Hypoxic Ischemic Encephalopathy; Perinatal Asphyxia; Therapeutic Hypothermia; Neonates

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