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Background <p>Neonatal encephalopathy (NE) following perinatal asphyxia remains one of the main causes of neonatal mortality and the development of long-term neurodevelopmental sequelae. Therapeutic hypothermia (TH) is currently the only established treatment for moderate to severe NE but there is still a&#xa0;relevant mortality and a&#xa0;high risk of adverse long-term outcomes. Early prognosis regarding the long-term outcome can help to make therapeutic decisions, initiate early neuroprotective and neurorehabilitative interventions and to advise families.</p> Objective <p>In this review article we aim to provide an overview of possible parameters to help predict long-term outcomes in neonates with NE following TH.</p> Methods <p>We systematically evaluated possible prognostic parameters to develop a&#xa0;clinically applicable guide to assess the long-term outcome following TH.</p> Results <p>Significant parameters predicting long-term outcomes in neonates with NE following TH include the lack of normalization of the (a)&#xa0;EEG after 48 h, the permanent absence of a&#xa0;sleep-wake cycle in the (a)&#xa0;EEG and the presence of status epilepticus on the (a)&#xa0;EEG as well as magnetic resonance imaging (MRI) and cerebral ultrasound findings. Standardized neurological examinations are highly informative, particularly regarding long-term motor outcomes. Clinical information in the first hours of life, such as 1‑min, 5‑min and 10 min Apgar index scores, pH, base excess, lactate levels, and Sarnat-Thompson scores do not enable long-term outcome prediction, but help to identify neonates who are likely to benefit from TH.</p> Conclusion <p>Prediction of long-term outcome in neonates with NE should be made in a&#xa0;synopsis of all clinical, laboratory, radiological and functional diagnostics.</p>

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Prognoseparameter neurologischer Langzeitschäden asphyktischer Neugeborener nach therapeutischer Hypothermie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月27日

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  • Anne Groteklaes,
  • Till Dresbach,
  • Sebiha Demir,
  • Andreas Müller,
  • Hemmen Sabir

摘要

Background

Neonatal encephalopathy (NE) following perinatal asphyxia remains one of the main causes of neonatal mortality and the development of long-term neurodevelopmental sequelae. Therapeutic hypothermia (TH) is currently the only established treatment for moderate to severe NE but there is still a relevant mortality and a high risk of adverse long-term outcomes. Early prognosis regarding the long-term outcome can help to make therapeutic decisions, initiate early neuroprotective and neurorehabilitative interventions and to advise families.

Objective

In this review article we aim to provide an overview of possible parameters to help predict long-term outcomes in neonates with NE following TH.

Methods

We systematically evaluated possible prognostic parameters to develop a clinically applicable guide to assess the long-term outcome following TH.

Results

Significant parameters predicting long-term outcomes in neonates with NE following TH include the lack of normalization of the (a) EEG after 48 h, the permanent absence of a sleep-wake cycle in the (a) EEG and the presence of status epilepticus on the (a) EEG as well as magnetic resonance imaging (MRI) and cerebral ultrasound findings. Standardized neurological examinations are highly informative, particularly regarding long-term motor outcomes. Clinical information in the first hours of life, such as 1‑min, 5‑min and 10 min Apgar index scores, pH, base excess, lactate levels, and Sarnat-Thompson scores do not enable long-term outcome prediction, but help to identify neonates who are likely to benefit from TH.

Conclusion

Prediction of long-term outcome in neonates with NE should be made in a synopsis of all clinical, laboratory, radiological and functional diagnostics.