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Therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy is associated with short-term reduction of seizures after discharge from the neonatal intensive care unit

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Abstract

Introduction

Therapeutic hypothermia for the treatment of moderate to severe neonatal hypoxic ischemic encephalopathy has been shown to reduce death and disability, but the effects on seizures after discharge from the Neonatal ICU are not known.

Methods

A retrospective cohort study was conducted involving 56 neonates admitted to the Neonatal ICU at Children’s Hospital of Orange County, CA from January 1, 2007 to September 1, 2013 with hypoxic ischemic encephalopathy who met criteria for selective brain cooling. Fifteen patients received supportive care. Forty-one patients received cooling, of whom 25 were included for analysis. Sixteen patients from the hypothermia group and 12 from the no hypothermia group developed clinical seizures while inpatient. Up to 6 months, four patients (16%) had continued seizures in the therapeutic hypothermia group compared to eight (53%) patients who did not receive hypothermia.

Discussion

Our study shows an association between therapeutic hypothermia and reduced seizures after discharge from the neonatal intensive care unit. The short duration of follow-up, 6 months, is a limitation of this study. Another limitation is its observational nature, where reasons for treatment selection and exclusions are unmeasurable confounding factors. Further studies are needed to determine long-term effects.

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Acknowledgements

We would like to acknowledge Dr. Peter Kang at the University of Florida for editorial support.

Author contributions

SG: study design, data collection, analysis, and manuscript. LT: study design, EEG interpretation, analysis, and manuscript. JJS: data collection and analysis. MLZ: study design, analysis, manuscript, and senior mentorship.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Neurology, College of Medicine, University of Florida, Gainesville, FL, 32610, USA

    Suman Ghosh

  2. Department of Pediatrics, Division of Child Neurology, Children’s Hospital of Orange County, University of California Irvine, Orange, CA, USA

    Lily Tran & Mary L Zupanc

  3. Department of Health Outcomes and Policy, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA

    Jonathan J Shuster

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  1. Suman Ghosh
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  2. Lily Tran
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  3. Jonathan J Shuster
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  4. Mary L Zupanc
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Corresponding author

Correspondence to Suman Ghosh.

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Conflict of interest

The authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Financial disclosure/funding

Research reported in this publication was partly supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Ethical approval

The Children’s Hospital of Orange County Institutional Review Board approved the conduct of this study.

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Ghosh, S., Tran, L., Shuster, J.J. et al. Therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy is associated with short-term reduction of seizures after discharge from the neonatal intensive care unit. Childs Nerv Syst 33, 329–335 (2017). https://doi.org/10.1007/s00381-016-3321-x

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  • DOI: https://doi.org/10.1007/s00381-016-3321-x

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