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CC BY 4.0 · Journal of Child Science 2021; 11(01): e280-e286
DOI: 10.1055/s-0041-1736562
Original Article

Outcome of Infants with Hypoxic-Ischemic Encephalopathy Treated by Whole Body Cooling and Magnesium Sulfate

Safwat M. Abdel-Aziz 
1   Department of Pediatrics and Neonatology, Assiut University Children's Hospital, Assiut, Egypt
,
Mohamed Sabry M. Abdel Rahman
1   Department of Pediatrics and Neonatology, Assiut University Children's Hospital, Assiut, Egypt
,
Asmaa H. Shoreit
1   Department of Pediatrics and Neonatology, Assiut University Children's Hospital, Assiut, Egypt
,
Moustafa Ez El Din 
2   Department of Radiology, Faculty of Medicine, Assiut University, Assiut, Egypt
,
Enas A. Hamed 
3   Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
,
Eman Fathalla Gad
1   Department of Pediatrics and Neonatology, Assiut University Children's Hospital, Assiut, Egypt
› Author Affiliations Funding None.
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Abstract

Therapeutic hypothermia (TH) either by selective head cooling or whole-body cooling decreases brain damage and provide neuroprotection and reduced mortality rate in cases of moderate-to-severe hypoxia-ischemia encephalopathy (HIE) of newborns, especially if started at first 6 hours after birth. Also, management with adjuvant therapies like magnesium sulfate (MS) provides more neuroprotection. The interventional randomized controlled research aimed to assess short-term actions of TH as sole therapy and in combination with MS as a neuroprotective agent for the treatment of HIE newborn infants. A total of 36 full-terms and near-term infants delivered at Assiut University Children's Hospital and fulfilled HIE criteria were enrolled. They were divided equally into three groups; Group 1 (n = 12) received whole body cooling during first 6 hours of life as a sole therapy; Group 2 (n = 12) received whole body cooling in addition to MS as adjuvant therapy; Group 3 (n = 12) received supportive intensive care measures as a control. TH plus MS group (group 2) had a significantly good short-term outcomes as short period of respiratory support and mechanical ventilation (p-value =0.001), less in incidence of convulsion (p-value = 0.001) and early in feeding initiation (p-value = 0.009), compared with other groups managed by TH (group 1) or by supportive treatment (group 3). In conclusion, whole body cooling in addition to MS as adjunctive therapy for the treatment of HIE neonates is safe therapy that improves short-term outcome both clinically and radiologically.

Keywords

hypoxic-ischemic encephalopathy - magnesium sulfate - neuroprotective - therapeutic hypothermia

Author's Contributions

M.S.M.A.R. carried the study design, examined cases, and shared in writing of manuscript. A.H.S. selected the cases, did the validation, and coding, shared in writing manuscript. M.E.E.D. was involved in the selection of cases, MRI reading and interpretation and shared in writing manuscript and gathered references. E.A.H. did the validation, analysis of data and coding, shared in writing manuscript, reviewed and edited. S.M.A.-A. did the study design, conceptualization, writing manuscript, validation, and editing. All authors had read and approved manuscript for publication.




Publication History

Received: 01 July 2021

Accepted: 30 August 2021

Article published online:
03 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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