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OP-088 Can neuroimaging be a part of the criteria for therapeutic hypothermia?
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  1. Özlem Şahin,
  2. İlke Mungan Akın
  1. Health Sciences University Ümraniye Training and Research Hospital, Neonatal Intensive Care Unit

Abstract

Aim Hypoxic-ischemic encephalopathy(HIE) in neonates is associated with neonatal seizures, brain damage, and life-long sequela and epilepsy. Neonatal convulsion on the 1st day of life is the most important determinant of moderate HIE. The only accepted treatment method for moderate to severe HIE is therapeutic hypothermia(TH), but since it is not 100% effective and has side effects, the approach of getting help from cranial imaging methods to decide for TH has been increasing in recent years. In this study, we aimed to evaluate the correlation of convulsions with the neuro-imaging in HIE patients who underwent TH.

Material and Method This retrospective study was performed on HIE cases treated with TH between January 2020–2024. All of the patients were monitored with aEEG during TH and diffusion MR and daily TFUSG were evaluated within the 1stweek by a pediatric radiologist. Patients were divided into two according to the presence of convulsions. The sociodemographic characteristics, risk factors, birth history, anticonvulsants, and radiological evaluations were recorded.

Results Out of 79 patients, 20(25.3%) had convulsions; 9(11.4%) were diagnosed clinically, 6(7.6%) with aEEG, 5(6.3%) with clinical+aEEG, and phenobarbital was used in 10(12.7%), levatiracetam in 4(5.1%), and phenobarbital+levatiracetam in 6(7.6%) patients. On TFUSG 17(21.5%) had findings compatible with HIE and 7(8.9%) with bleeding. 19(24.1%) diffusion MRI were reported as diffusion restricted. No significant differences were observed between the patient groups with and without convulsions, in demographic findings, risk factors, cord pH, APGAR scores and terms of TFUSG and diffusion MRI findings (p>0.05 for all).

Conclusions In this study, the presence of convulsions is not correlated with the pathological findings in neuroimaging. Neuroimaging modalities in HIE can not be prioritized for the onset of TH.

  • neonates
  • therapeutic hypothermia
  • hypoxic ischemic encephalopathy
  • neuroimaging

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