Mild HIE: incidence, consequences, perspective and effectiveness of controlled hypothermia treatment

Czech version

Authors: K. Demová; J. Biroš; O. Zaikina; M. Kovácsová
Authors‘ workplace: Neonatologická klinika, FNsP, Nové Zámky
Published in: Čes-slov Neonat 2023; 29 (1): 34-41.
Category: Reviews

Overview

Recently, there is increasing evidence that neonates with mild hypoxic-ischemic encephalopathy (HIE) are at significant risk of mortality, brain damage, and adverse neurodevelopment. Abnormal short-term outcomes seen in neonates with mild HIE include convulsions, abnormal neurologic findings at discharge, feeding disorders, and abnormal brain findings on magnetic resonance imaging. At 2 to 3 years of age, mild HIE is associated with an increased risk of autism, language, and cognitive deficits. Newborns after perinatal asphyxia are usually diagnosed within 6 hours after birth. This time window corresponds to the possibility of treating moderate to severe HIE. There are no well-established treatment strategies for the group of neonates with mild HIE, as these were not included in the initial randomized controlled trials of therapeutic hypothermia. Currently, many centers are using therapeutic hypothermia (TH) in the treatment of mild HIE, despite limited evidence of its safety and efficacy. Randomized controlled trials are needed to establish the safety, efficacy, and optimal duration of treatment of mild HIE with TH. The work deals with the search for the definition of mild HIE and its incidence, summarizes the evidence on the adverse consequences of mild HIE, and at the same time with the search for additional diagnostic aids for the creation of therapeutic strategies for mild HIE.

Keywords:

therapeutic hypothermia – Prognosis – biomarkers – neuroprotection – mild HIE

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Article was published in

Czech and Slovak Neonatology

2023 Issue 1