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Master Thesis

Neuroprotection par hypothermie des nouveau-nés à terme atteints d'encéphalopathie anoxo-ischémique : description des facteurs pronostiques d'une cohorte Bordelaise

Abstract : Aim: to investigate the clinical, biological, electrophysiological and imaging features associated with death or neurological impairment at one year of age, in term neonates with hypoxic ischemic encephalopathy (HIE) treated by therapeutic hypothermia (TH). Methods: our study is a monocentric retrospective descriptive one. Term newborns with a moderate or severe HIE treated by TH were consecutively included during two years. TH was initiated within the 6th hour after birth and lasted 72 hours. In all patients, a brain MRI before the eighth day was performed and at least two electroencephalograms were recorded. All neonates had a clinical evaluation at one year of age. Results: among the 33 patients included, 20 neonates had a favourable outcome at one year of age, and 13 had an unfavourable outcome (death (9) or moderate or severe neurological impairment). In our series, early clinical seizures (15% vs 53.8%, p = 0.047), the persistence of poor prognosis electroencephalogram pattern after TH (0% vs 69.2%, p = 0.0001) and early brain MRI score (median score of 2 vs 11, p < 0.001) combined with high value of Lactate/N-acetyl aspartate ratio (0.52 vs 1.33, p = 0.008) on spectroscopy were significantly associated to death and poor neurological outcome at one year of age. Conclusion: combination of clinical, electrophysiological and imaging features can help the medical team to establish the most reliable prognosis of those full-term neonates, to orient care and inform parents the most appropriate and sincere way.
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https://dumas.ccsd.cnrs.fr/dumas-03288185
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Submitted on : Friday, July 16, 2021 - 11:13:47 AM
Last modification on : Saturday, August 28, 2021 - 3:12:30 AM
Long-term archiving on: : Sunday, October 17, 2021 - 6:31:44 PM

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  • HAL Id : dumas-03288185, version 1

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Justine Labat. Neuroprotection par hypothermie des nouveau-nés à terme atteints d'encéphalopathie anoxo-ischémique : description des facteurs pronostiques d'une cohorte Bordelaise. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03288185⟩

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