Effects of Whole Body Therapeutic Hypothermia on Gastrointestinal Morbidity and Feeding Tolerance in Infants with Hypoxic Ischemic Encephalopathy

Abstract

Objective. This retrospective cohort study evaluated the effects of whole body therapeutic hypothermia (WBTH) on gastrointestinal (GI) morbidity and feeding tolerance in infants with moderate-to-severe hypoxic ischemic encephalopathy (HIE). Study Design. Infants ≥ 35 weeks gestational age and ≥1800 grams birth weight with moderate-to-severe HIE treated from 2000 to 2012 were compared. 68 patients had documented strictly defined criteria for WBTH: 32 historical control patients did not receive WBTH (non-WBTH) and 36 cohort patients received WBTH. Result. More of the non-WBTH group infants never initiated enteral feeds (28% versus 6%; P=0.02), never reached full enteral feeds (38% versus 6%, P=0.002), and never reached full oral feeds (56% versus 19%, P=0.002). Survival analyses demonstrated that the WBTH group reached full enteral feeds (median time: 11 versus 9 days; P=0.02) and full oral feeds (median time: 19 versus 10 days; P=0.01) sooner. The non-WBTH group had higher combined outcomes of death and gastric tube placement (47% versus 11%; P=0.001) and death and gavage feeds at discharge (44% versus 11%; P=0.005). Conclusion. WBTH may have beneficial effects on GI morbidity and feeding tolerance for infants with moderate-to-severe HIE.