Neurological outcomes in neonates treated with therapeutic hypothermia: challenges in a developing country

Abstract: Background Hypoxic-ischemic encephalopathy (HIE) affects 1.5 newborns per 1 thousand term live births. Therapeutic hypothermia (TH) does not prevent all adverse outcomes. The experience with TH is still limited in Latin America. In Rio de Janeiro, Hospital Universitário Pedro Ernesto treats neonates with HIE since 2017 using the servo-controlled system. Objective To describe the frequency of epilepsy, altered neurological exam, and neurodevelopmental delay at 12 months of age in patients treated with TH in a reference hospital in Rio de Janeiro and to evaluate the possible risk associations with clinical data and data from complementary exams. Methods We evaluated medical records from the Neonatal Intensive Care Unit hospitalization and from first evaluation recorded at 12 months of age in the High-Risk Neonate Follow-up Outpatient Sevice. Results A total of 30 subjects were included in the study. We found epilepsy in 18.2% of the patients, altered neurological exam in 40.9%, and neurodevelopmental delay in 36.4%. We also found a significant relationship between altered magnetic resonance imaging scan and subsequent altered neurological exam. Our findings are in line with those of the international literature, which shows that adverse outcomes are still observed, even when TH is applied. Brazilian data shows our limited access to complementary exams. The rate of loss to follow-up was of 26.6%, probably due to the coronavirus disease 2019 (COVID-19) pandemic and to unfavorable socioeconomic conditions. More time for prospective follow-up and protocol adjustments should contribute to improve our data. Conclusion High incidences of epilepsy, altered neurological exams, and neurodevelopmental delay were found, despite the use of TH. A more efficient use of resources is needed, as well as measures such as early intervention.

Object Details

• Alternative title: Desfechos neurológicos em neonatos tratados com hipotermia terapêutica: desafios em um país em desenvolvimento
• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Neurological outcomes in neonates treated with therapeutic hypothermia: challenges in a developing country ; volume:82 ; number:09 ; year:2024 ; pages:001-008 ; Arquivos de neuro-psiquiatria ; 82, Heft 09 (2024), 001-008

Contributors, Places and Time

• Contributor: Oliveira, Rita Farias ; Wagner, Lucia Helena ; Silva, Alexandre Sousa da ; Rodrigues, Maura Calixto Cecherelli de ; Lacerda, Glenda Corrêa Borges de

Further information

• DOI: 10.1055/s-0044-1790575
• URN: urn:nbn:de:101:1-2411281121184.516467100527
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:29 AM CEST