Long Term Neurodevelopmental Outcomes in Children with Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy (HIE)
Keywords:
Therapeutic hypothermia, long term neurodevelopmental outcomes, HIE, MSEL, GMFMAbstract
Background: Therapeutic hypothermia (TH) become a standard of care for moderate to severe HIE since 2005, mentioned to decrease mortality and sequelae such as developmental disability and cerebral palsy. In Thailand, QSNICH and Chonburi hospital used TH as standard treatment since 2011 and 2013 respectively. Data of long term outcome are limited
Objectives: To assess neurological conditions and developmental outcomes, associated factors and long-term effects of children aged 12 months to 60 months who got therapeutic hypothermia at QSNICH and Chonburi Hospital.
Methods: A cross-sectional descriptive study of 18 enrolled participants, Mullen scale of early learning (MSEL), Gross Motor Function Measure (GMFM), Gross Motor Function Classification System (GMFCS) assessment of patients and collected data such as socioeconomic family status, caregivers’ education, Test of Nonverbal Intelligence Fourth Edition, Modified Checklist for Autism in Toddlers, Pervasive Developmental Disorder Screening Questionnaire and also perinatal history.
Result: Mean cognitive function from MSEL was 70.33 ± 25.16, 11 children performed very low level (61.1%) and one was below average (5.6%). GMFCS assessment was found normal function 77.8% and severe disability 22.2%. Head circumference below P3 correlated with abnormal gross motor function. Low mean pH in blood gas at 1 hour after birth correlated
with abnormal fine motor, statistically significant. Conclusion: Neurodevelopmental outcome of children in this study was found lower level than average and severe disability by GMFCS, no significant factor correlated with these results. In addition, it was found that gross and fine motor function correlated with some factor during Therapeutic Hypothermia.
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