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Neonatal encephalopathy multiorgan scoring systems: systematic review.

Noor Adeebah Mohamed Razif1, Aidan D'Arcy1, Sarah Waicus1

  • 1Discipline of Pediatrics, Trinity College Dublin, The University of Dublin, Dublin, Ireland.

Frontiers in Pediatrics
|October 17, 2024
PubMed
Summary

Neonatal encephalopathy (NE) multiorgan dysfunction (MOD) scoring systems show significant heterogeneity. A standardized system should include neurological, renal, hepatic, respiratory, hematological, and cardiovascular assessments for neonates.

Keywords:
brain injurymultiorgan dysfunction scoreneonatal encephalopathyscoring systemtherapeutic hypothermia

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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.