WIP 07 - Exploring the Correlation Between Respiratory Rate and MRI Outcomes in Neonates Undergoing Therapeutic Hypothermia for Hypoxic-Ischemic Encephalopathy (HIE)

Publication Number: WIP 07.7656

Gagandeep S. Dhugga, University of California Davis Children's Hospital, Sacramento, CA, United States; Deepika Sankaran, University of California Davis Children's Hospital, Sacramento, CA, United States; Satyan Lakshminrusimha, UC Davis, Sacramento, CA, United States

Background: Hypoxic-ischemic encephalopathy (HIE) is a common cause of neonatal encephalopathy. Currently, the only effective therapeutic intervention to improve outcomes in HIE is therapeutic hypothermia. Hypocapnia in the early post-natal period is associated with adverse short- and long-term neurological outcomes. Additionally, hypercapnia following recovery from asphyxia can result in cerebral hyperemia and reperfusion injury. However, readily measurable factors affecting PaCO2 such as respiratory rate (which can influence duration of exposure to hypo- and hypercapnia) and its effect on neurological outcomes have not been previously investigated.

Objective: To study the association between the respiratory rate in the early postnatal period and severity of neurological injury on brain MRI among infants with moderate-to-severe HIE treated with therapeutic hypothermia.

Design/Methods: This will be a retrospective chart review, including neonates admitted to the NICU at an academic hospital between 2018-2023 who underwent therapeutic hypothermia for moderate-to-severe HIE. Exclusion criteria include neonates with a gestational age of less than 34 6/7 weeks and those with large intracranial hemorrhage. The total number of patients in this study is going to be around 119 patients. For included patients, respiratory rates within the first 12 hours of life will be averaged and compared to brain MRI findings obtained 5-7 days after birth. Other data will also be collected including: APGAR scores, risk factors for asphyxia, severity of HIE, blood gasses, FiO2 requirements, blood pressure (before and after cooling), initial respiratory support, and seizures. IRB approval has been obtained, and data collection is nearing completion. In November, data collection will be completed and data analysis will be performed in December.