Haemodynamic and neurophysiological assessments for 2-year outcome prediction in neonates with hypoxic-ischaemic encephalopathy treated with therapeutic hypothermia: a systematic review and meta-analysis.
Mona Noureldein, Vincent So, Lamia M Hayawi et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the prognostic accuracy of amplitude-integrated electroencephalography (aEEG), cerebral near-infrared spectroscopy (cNIRS), and targeted neonatal echocardiography (TnECHO) for predicting 2-year outcomes in infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia. The analysis included 37 studies with 2721 infants, revealing that abnormal aEEG background at 36 hours predicted adverse outcomes with a sensitivity of 0.83 and specificity of 0.88.
Key findings
- Abnormal aEEG background at 36 hours had a sensitivity of 0.83 and specificity of 0.88 for predicting adverse outcomes.
- Absence of sleep-wake cycling showed high specificity of 0.93 and DOR of 30.19.
- cNIRS demonstrated potential prognostic value with specificity of 0.97 at 36-48 hours.
- Acute pulmonary hypertension had low overall discrimination with a DOR of 2.17.
Why it matters
Understanding the prognostic capabilities of these assessments can aid clinicians in making informed decisions regarding the management and counseling of families with infants affected by HIE, potentially improving long-term outcomes.