Neonatal encephalopathy multiorgan scoring systems: systematic review

Area of Science:

• Neonatal medicine
• Pediatric neurology
• Critical care

Background:

• Neonatal encephalopathy (NE) is a serious condition causing multiorgan injury in newborns.
• Therapeutic hypothermia (TH) is the standard treatment, but assessing the severity of multiorgan dysfunction (MOD) in NE remains challenging.
• Current approaches to MOD assessment in NE lack standardization.

Purpose of the Study:

• To identify current approaches for assessing multiorgan dysfunction (MOD) in neonatal encephalopathy (NE).
• To determine an optimal scoring system for MOD in NE based on a systematic review of existing literature.

Main Methods:

• A systematic review was conducted following PRISMA guidelines.
• Searches were performed across multiple databases (PubMed, EMBASE, MEDLINE, Cochrane, Scopus, CINAHL) for studies on MOD scoring systems in NE.
• Data from 12 included studies were extracted and analyzed.

Main Results:

• Five studies demonstrated a positive correlation between NE severity and MOD.
• Significant heterogeneity was observed in scoring systems regarding eligibility criteria, organ system assessment methods, follow-up duration, and outcomes.
• Neurological, hepatic, cardiovascular, respiratory, hematological, and renal systems were commonly included, while the gastrointestinal system was less frequent.

Conclusions:

• An ideal NE multiorgan scoring system should encompass neurological, renal, hepatic, respiratory, hematological, and cardiovascular systems.
• Despite heterogeneity, these systems offer candidates for standardizing MOD scoring in NE.
• Further validation and consideration of therapeutic hypothermia's effects are necessary.