Abstract
Objective This study aimed to assess the incidence of hypotension in asphyxiated newborns treated
with hypothermia, the variability in treatments for hypotension, and the impact of
hypotension on the pattern of brain injury.
Study Design We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia.
Mean blood pressures, lactate levels, and inotropic support medications were recorded
during the hospitalization. Presence and severity of brain injury were scored using
the brain magnetic resonance imaging (MRI) obtained after the hypothermia treatment
was completed.
Results One hundred and ninety term asphyxiated newborns were treated with hypothermia. Eighty-one
percent developed hypotension. Fifty-five percent of the newborns in the hypotensive
group developed brain injury compared with 35% of the newborns in the normotensive
group (p = 0.04). Twenty-nine percent of the newborns in the hypotensive group developed severe
brain injury, compared with only 15% in the normotensive group. Nineteen percent of
the newborns presenting with volume- and/or catecholamine-resistant hypotension had
near-total injury, compared with 6% in the normotensive group and 8% in the group
responding to volume and/or catecholamines.
Conclusion Hypotension was common in asphyxiated newborns treated with hypothermia and was associated
with an increased risk of (severe) brain injury in these newborns.
Keywords
birth asphyxia - brain - neonatal encephalopathy - hypotension - inotrope score -
newborn
