Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 8, August, p. 1011–1016

doi: 10.17219/acem/124437

Publication type: review article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Methods for assessing the severity of perinatal asphyxia and early prognostic tools in neonates with hypoxic–ischemic encephalopathy treated with therapeutic hypothermia

Wojciech Walas1,A,B,C,D,E,F, Maria Wilińska2,A,B,F, Monika Bekiesińska-Figatowska3,A,B,F, Zenon Halaba4,A,B,F, Robert Śmigiel5,A,B,E,F

1 Pediatric and Neonatal Intensive Care Unit, University Hospital in Opole, Poland

2 Department of Neonatology, Centre of Postgraduate Medical Education, Warszawa, Poland

3 Department of Diagnostic Imaging, Institute of Mother and Child, Warszawa, Poland

4 Department of Pediatrics, Institute of Medical Sciences, University of Opole, Poland

5 Department of Pediatrics, Division of Propaedeutic Pediatrics and Rare Disorders, Wroclaw Medical University, Poland

Abstract

Despite the progress in perinatal care, perinatal asphyxia (PA) remains a significant problem in neonatology. The development of therapeutic hypothermia (TH) has improved the prognosis, but it still remains uncertain in hypoxic neonates. The evaluation of the severity of ischemia/hypoxia after birth is crucial to the choice of treatment, and with accurate long-term prognosis, appropriate further patient care can be planned. This article presents various methods for the preliminary assessment of brain damage and prognosis in newborns with PA treated with TH. The importance of assessing the neurological condition and the usefulness of laboratory and electrophysiological testing and imaging are discussed. New methods are also noted, which are at the stage of clinical trials. A combination of the prognostic tests presented in this article can provide greater prognostic accuracy for predicting long-term neurological outcomes in infants with hypoxic–ischemic encephalopathy (HIE) undergoing TH than either of these tests independently. Acknowledging the limitations of individual tools in certain clinical situations and the integration of the information available from multiple biomarkers may help improve the accuracy of prognostication.

Key words

perinatal asphyxia, neonate, prediction factors, therapeutic hypothermia, hypoxic–ischemic encephalopathy

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