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Published on: September 2, 2010
Cold injury syndrome and neurodevelopmental changes in survivors
1Department of Pediatrics, Clinical Hospital Split, Spinciceva, Croatia. srdjana.culic@st.htnet.hr
Insights
Cold injury syndrome (CIS) in infants can lead to serious health issues. Early detection and treatment of hypothermia are crucial for reducing mortality and preventing long-term neurodevelopmental disturbances in newborns.
Area of Science:
- Neonatalogy
- Pediatric Critical Care
- Hypothermia Research
Background:
- Cold injury syndrome (CIS) poses significant risks to infants and newborns.
- Morbidity, mortality, and neurodevelopmental issues are associated with CIS.
- Understanding clinical parameters is key to reducing adverse outcomes.
Purpose of the Study:
- To expand knowledge on clinical features of CIS in hypothermic neonates.
- To identify factors influencing morbidity, mortality, and neurodevelopmental outcomes.
- To inform strategies for improved patient management and outcomes.
Main Methods:
- A retrospective 10-year cohort study.
- Involved 103 hypothermic infants and newborns (0-60 days).
- Analyzed records of survivors and deceased, with neurodevelopmental assessment for some survivors.
Main Results:
- Common symptoms included cold extremities, lethargy, hypotonia, cyanosis, bradycardia, bradypnea, and apneic crisis (AC).
- Diffuse intravascular coagulation (DIC) was prevalent.
- Higher admission temperatures correlated with reduced mortality; 66.7% of assessed survivors had neurodevelopmental disturbances.
Conclusions:
- Severity of hypothermia, leukopenia, and thrombocytopenia with DIC predicts prognosis.
- Hypothermia in neonates can result in psychological and neurodevelopmental issues for survivors.
Background:
The aim of this study was to extend and develop knowledge of the clinical parameters of cold injury syndrome (CIS) in hypothermic infants and newborns, so that morbidity, mortality, and neurodevelopmental disturbances associated with the condition can be reduced.
Methods:
This retrospective, 10-year cohort study investigated 103 hypothermic infant and newborn patients (aged 0-60 days) admitted to the Pediatric Department between January 1, 1976 and December 31, 1985. Medical records of 67 survivors and 36 children who died were analyzed. Of the survivors, 24 consented to undergo assessment of neuropsychological and neurodevelopmental outcomes.
Results:
At presentation, all patients manifested cold skin and limbs, while 96 (93.2%) were sleepy, hypotonic and inactive. Cyanosis with bradycardia, bradypnea, and apneic crisis (AC) was observed in 80 (77.7%) patients, and 65 (63.1%) demonstrated diffuse intravascular coagulation (DIC). Pulmonary hemorrhage, AC, respiratory distress syndrome, and DIC represented the primary causes of death. Higher body temperatures on admission reduced the risk of death. Of the 24 patients assessed for neuropsychological and neurodevelopmental outcomes, all but one had normal intellectual capabilities, whereas 16 (66.7%) showed signs of neurodevelopmental disturbances.
Conclusions:
The severity of hypothermia, leukopenia, and thrombocytopenia with DIC correlates with prognosis and death rate. Hypothermia in infants and newborns can cause psychological and neurodevelopmental disturbances in survivors.
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