Cerebral oximetry as a predictor of early outcome in newborns with hypoxic - ischemic encephalopathy

Abstract

Hypoxic-ischemic encephalopathy (HIE) is a major cause of greater neonatal morbimortality and permanent disability. Its incidence is 1,6 of 1000 live newborns and it is higher in developing countries. Nowadays, it is not possible to know the prognosis with certainty of newborns with HIE. We have tests and classifications which help us in the prognosis but still, the outcome is uncertain. Cerebral oximetry is a non-invasive and simple test which could help us to know more precisely the severity of the brain damage and the future prognosis of the infant. Our objective is to analyze if the values of the cerebral oximetry have prognostic value in HIE using a defined protocol. This is a descriptive study and it will take place in six hospitals in Catalunya and it will last three years in order to get the sample size needed. We will study 69 patients with different grades of HIE following a non-probabilistic, consecutive sampling. We will study if cerebral oximetry ́s values can predict the early outcome of hypoxic-ischemic encephalopathy in neonates measured in ranges which are pathological (<55% and >90%) and normal ranges (55% to 85%) and secondary, we will analyze if more pathological values in cerebral oximetry are associated with those electroencephalographic paths which are related to the worst outcome as discontinuous, burst-suppression and convulsions and if more pathological values in cerebral oximetry are translated into greater brain affectation in magnetic resonance and sequels risk. We will record data (sex, gestational age, pH, temperature, aEEG, cerebral oximetry values, renal oximetry values, and magnetic resonance results) hourly for 96 hours from the birth and we will analyze it using descriptive analysis, bivariant analysis and multivariant analysis