Outcome of Infants with Therapeutic Hypothermia after Perinatal Asphyxia and Early-Onset Sepsis

Abstract

<b><i>Background:</i></b><i></i> Animal models suggest that neuroprotective effects of therapeutic hypothermia (TH) after perinatal asphyxia are reduced in infants with early-onset sepsis. <b><i>Objectives:</i></b> To assess the outcome of infants with perinatal asphyxia, neonatal encephalopathy, and TH in the presence of early-onset sepsis. <b><i>Methods:</i></b> In a retrospective cohort of 1,084 infants with perinatal asphyxia and TH, the outcome of 42 infants (gestational age 36.1–42.6 weeks and birth weight 2,280–5,240 g) with proven sepsis (<i>n</i> = 14) and probable sepsis (<i>n</i> = 28) was analyzed. Death, cerebral palsy, or a delayed development at 2 years was considered an adverse outcome. <b><i>Results:</i></b> Sepsis was caused mostly by group B streptococci (<i>n</i> = 17), other Gram-positive bacteria (<i>n</i> = 5), and <i>Candida albicans</i> (<i>n</i> = 1). Of the 42 infants, 9 (21.4%) died, and 5 (11.9%) showed impairments on follow-up. The outcome is comparable to the previously reported outcome of infants with TH without early-onset sepsis. <b><i>Conclusion:</i></b> A good outcome was reported in the majority of infants with perinatal asphyxia, TH, and early-onset sepsis. Cooling should not be withheld from these infants.