Clinical profile, mortality and short term outcome in asphyxiated neonates treated with therapeutic hypothermia in limited-resource setting, a cohort study

Abstract

Objective :To evaluate the effectiveness of therapeutic hypothermia(TH) among asphyxiated newborns for reducing mortality, adverse clinical events, and short-term outcomes in comparison to asphyxiated newborns treated with standard therapy. Material and method: Non-randomised cohort study at the tertiary care center. Study population: Asphyxiated newborns admitted in NICU within 24 hrs of life meeting the lab and/or clinical criteria of Severe Birth Asphyxia. Eligible newborns who received TH were labeled as recipients and newborns who received standard care were labeled as non-recipient. Results: Out of 176 infants studied, 89 newborns received TH, and 87 newborns received standard care. Recipients of TH had 15.3% lower mortality than non-recipients (P<0.05). The incidence of adverse clinical events was similar among both groups. At discharge 73.2% among recipients vs 56.8% non recipients were neurologically normal( p=0.01). 92.6% among recipients vs 70.1% non recipients were able to breast feed (p<0.05), 30.4% of recipients vs 46.2% non-recipients required anti-epileptics(p<0.05). Conclusion: TH is effective and feasible with a decrease in the rate of death, better neurological status at discharge, and less need for anti-epileptics without increasing adverse clinical events at limited-resource settings using low-cost devices.