Abstract
Objective
To characterize variations in practices and outcomes for neonates with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) across Canadian tertiary Neonatal Intensive Care Units (NICUs).
Study design
Retrospective study of neonates admitted for HIE and treated with TH in 24 tertiary NICUs from the Canadian Neonatal Network, 2010–2020. The two primary outcomes of mortality before discharge and MRI-detected brain injury were compared across NICUs using adjusted standardized ratios (SR) with 95% CI.
Results
Of the 3261 neonates that received TH, 367 (11%) died and 1033 (37%) of the 2822 with MRI results had brain injury. Overall, rates varied significantly across NICUs for mortality (range 5–17%) and brain injury (range 28–51%). Significant variations in use of inotropes, inhaled nitric oxide, blood products, and feeding during TH were identified (p values < 0.01).
Conclusion
Significant variations exist in practices and outcomes of HIE neonates treated with hypothermia across Canada.
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Acknowledgements
The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN.
Funding
MB holds an Early Career Investigator Grant from the CIHR Institute of Human Development, Child and Youth Health (IHDCYH), a Research Grant Funding from the FRSQ Clinical Research Scholar Career Award Junior 1, and an Early Career Investigator Grant from the Montreal Children’s Hospital Foundation. This study was supported by a grant from the Canadian Institutes of Health Research (CIHR) funding the Canadian Preterm Birth Network (PBN 150642). PW receives research grant funding from the FRSQ Clinical Research Scholar Career Award Junior 2 and a CIHR Project Grant.
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MB conceptualized and designed the study, collected the data, analyzed the data, drafted the manuscript, and adjusted the manuscript according to the comments of co-authors. PW, KM, EJ, JA, SS, DL, SR, KSL, CF, and PS provided review and critical appraisal of the manuscript.
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Beltempo, M., Wintermark, P., Mohammad, K. et al. Variations in practices and outcomes of neonates with hypoxic ischemic encephalopathy treated with therapeutic hypothermia across tertiary NICUs in Canada. J Perinatol 42, 898–906 (2022). https://doi.org/10.1038/s41372-022-01412-7
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DOI: https://doi.org/10.1038/s41372-022-01412-7
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