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293 The Myocardial Performance during and after 72-Hours of Therapeutic Hypothermia for Perinatal Asphyxia in Term Neonates
  1. E Nestaas1,
  2. J Skranes2,3,
  3. A Støylen4,5,
  4. D Fugelseth2,3
  1. 1Department of Paediatrics, Vestfold Hospital Trust, Tønsberg
  2. 2Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål
  3. 3Faculty of Medicine, University of Oslo, Oslo
  4. 4Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology
  5. 5Department of Cardiology, St. Olavs Hospital, Trondheim, Norway

Abstract

Background and Aims Therapeutic hypothermia after perinatal asphyxia reduces brain damage. The impact on the heart is poorly investigated. This study compare myocardial performance (MP) by ultrasound (Strain and Strain-Rate by tissue Doppler) in cooled asphyxiated term neonates (HT), asphyxiated term neonates treated with normothermia (NT) and non-asphyxiated term neonates (CTR).

Methods MP were compared in 44 HT during and after cooling, 20 NT and 48 CTR.

Results The HT-group was more severely asphyxiated than the NT-group (pH 7.07 (7.02, 7.12) (mean (95%CI)) vs. 7.21 (7.14, 7.30), Base-Excess –16.11mmol/L (–17.8, –14.3) vs. –9.3 (–13.0, –5.6) (p<0.05)).

On day 1–3, the MP was similar in the NT-group and HT-group during cooling, lower than in the CTR-group (p<0.05). The MP within each group was similar, except the CTR-group and HT-group Peak Systolic Strain and HT-group Strain-Rate during the Atrial Systole (p<0.05).

After rewarming, the MP improved in the HT-group (day 4), approaching the MP in the CTR-group on day 3.

Conclusions Although the HT-group was more severely asphyxiated than the NT-group, the myocardial performance was similarly depressed on day 1–3. The myocardial performance in the HT-group improved after rewarming (day 4), approaching the level in the CTR-group on day 3. Therapeutic hypothermia did not decrease the myocardial performance during treatment and might have had a positive impact after treatment.

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