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Universitas Medica

versão impressa ISSN 0041-9095versão On-line ISSN 2011-0839

Resumo

VARGAS-VACA, Yaris; DEVIA, Claudia; BERTOLOTTO, Ana María  e  SUAREZ-OBANDO, Fernando. Characterization of Newborns with Moderate or Severe Perinatal Asphyxia Managed with Selective Cerebral Hypothermia in the Newborn Unit of the Hospital Universitario San Ignacio from June 2015 to March 2017. Univ. Med. [online]. 2019, vol.60, n.4, pp.4-13. ISSN 0041-9095.  https://doi.org/10.11144/javeriana.umed60-4.crna.

Introduction:

Hypoxic- ischemic encephalopathy generates various alterations in the central nervous system of the newborn, with various consequences ranging from physical and mental disability to death. The evidence indicates that moderate to severe hypoxic-ischemic encephalopathy must be managed with therapeutic hypothermia.

Objectives:

Describe the clinical characteristics of a group of neonates treated by the therapeutic hypothermia team of the Neonatal Intensive Care Unit of the Hospital Universitario San Ignacio.

Methodology:

Sequential cross-section observational study, from June 2015 to March 2017. Continuous variables were compared using student's t-test. Relative frequency analysis was performed and compared according to variants of clinical interest using chi-square.

Results:

A total of 41 patients were treated by the program during the observation period. Clinical seizures were evident in 65% of the subjects. The main clinical outcome to discharge observed in the patients after the intervention was encephalopathy (90%). The clinical determinants of the birth of the neonate are compared with the death outcome where no significant differences were found proportionally between the two groups except for Apgar at 10 minutes and the presence of acidemia. For the outcome of death, RP greater than 1 in the case of Cesarean section, increased clotting time, thrombocytopenia, hypocalcemia and impaired renal function (p <0.05 and IC-95> 1).

Conclusions:

Low Apgar at 10 minutes and acidemia is associated with higher mortality. There was a greater prevalence of electrolyte and renal coagulation alterations in the group with lethal outcome. The time of onset of the therapy was related to seizures but not to death.

Palavras-chave : hypoxia; newborn; hypothermia; infant; diseases; perinatal mortality.

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