Background Hypoxic-ischemic encephalopathy (HIE) is associated with a high risk for subsequent neurological sequele. This study evaluates the implementation of HT in Sweden. Are national guidelines adhered to? Are outcome results comparable to those from previous controlled trials?
Methods Between 2007–2009, HT was available at 8 Swedish hospitals. Outcome data regarding all 187 infants who received HT during this period was collected and scored (normal/”motor delay”/cerebral palsy (CP)/dead). Local guidelines for clinical follow-up differing from the national guidelines were also reviewed.
Outcome data was available in 87% of treated infants. 13% had died, 74% had been assessed between 15–36 months of age with a neurological exam and using scales for grading of severity of CP, such as the Gross Motor Classification System. 35% had been assessed according to national guidelines using Bayley III.
Conclusions HT has been successfully implemented; however structured, comprehensive assessments according to national guidelines are not always carried out. In particular, only about 1/3 of infants undergo a psychometric developmental assessment. The incidence of severe adverse neuromotor outcome is comparable to what was to be expected from earlier RCTs, showing that HT has a significant positive effect also outside of controlled trials.