Article Text
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.