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Updated: Sep 23, 2025
Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
Association between multi-organ dysfunction and adverse outcome in infants with hypoxic ischemic encephalopathy
Elisabeth S Yan1, Valerie Y Chock1, Sonia Lomeli Bonifacio1
1Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, CA, USA.
Insights
Multi-organ dysfunction (MOD) is common in newborns receiving therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE). Increased MOD significantly correlates with severe brain injury or death, impacting clinical management.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Critical Care
Background:
- Hypoxic ischemic encephalopathy (HIE) is a serious condition in newborns.
- Therapeutic hypothermia (TH) is a standard treatment for HIE.
- The impact of multi-organ dysfunction (MOD) on HIE outcomes requires further investigation.
Purpose of the Study:
- To evaluate the incidence of multi-organ dysfunction (MOD) in newborns treated with therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE).
- To compare MOD in infants with normal/mild MRI findings versus those with moderate/severe MRI findings or death.
Main Methods:
- Retrospective, single-center observational study.
- Analysis of 16 parameters across 7 organ systems in 157 infants treated with TH.
- Primary outcome: death or moderate-to-severe brain injury on MRI.
Main Results:
- 77% of infants exhibited dysfunction in at least two organ systems.
- Higher number of dysfunctional organ systems strongly associated with adverse outcomes (p < 0.0001).
- Hematologic (68%) and hepatic (65%) dysfunction were most prevalent; neurologic and renal dysfunction showed strongest association with poor outcomes.
Conclusions:
- Multi-organ dysfunction (MOD) is highly prevalent in infants treated with TH for HIE.
- The degree of MOD is a significant predictor of adverse outcomes, including death or severe brain injury.
- Findings may influence clinical care strategies and patient counseling for HIE.
Objective:
To evaluate multi-organ dysfunction (MOD) in newborns treated with therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE), and to compare MOD in those with normal/mild magnetic resonance imaging (MRI) findings to those with moderate to severe MRI findings or death.
Study Design:
Retrospective single-center observational study of infants treated with TH. A total of 16 parameters across 7 organ systems were analyzed. Primary outcome was death or moderate to severe brain injury on MRI.
Result:
Of 157 infants treated with TH, 77% had ≥2 organ systems with dysfunction. The number of organ systems with dysfunction was strongly associated with death or moderate-to-severe brain injury (p < 0.0001). Hematologic (68%) and hepatic (65%) dysfunction were most common. Neurologic and renal dysfunction were most strongly associated with the primary outcome (OR 13.5 [6.1-29.8] and 11.2 [4.1-30.3], respectively), while pulmonary hypertension was not.
Conclusion:
MOD is prevalent in infants undergoing TH for HIE, and the association between MOD and adverse outcomes may impact clinical care and counseling.
