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. 2023 Mar 8;43(7):1180–1193. doi: 10.1177/0271678X231162174

Table 2.

Temperature, encephalopathy, and organ dysfunction by outcome.


n (% of available data)/Median (IQR)
p-value vs no NDI
Outcome group (n=) NDI-free survival (n = 112) Death/NDI (n = 55)
Encephalopathy parameters
 Severe Sarnat at randomization 16 (14.3) 23 (41.8) 0.0001
 Documented seizures 46 (41.4) 40 (72.7) 0.0001
 Esophageal temperature at TH initiation (°C) 34.5 (33.5–36.1) 33.5 (32.7–36.0) 0.007
Anticonvulsant medications
 Phenobarbital 39 (34.8) 37 (67.3) 0.0002
 Lorazepam (as anticonvulsant) 14 (12.5) 8 (14.5) 0.70
 Levetiracetam 6 (5.4) 7 (12.7) 0.11
 Other anticonvulsant 8 (7.1) 6 (10.9) 0.39
Analgesic medications
 Morphine 39 (34.8) 33 (60.0) 0.002
 Fentanyl 21 (18.8) 10 (18.2) 0.90
 Midazolam 33 (29.5) 15 (27.3) 0.77
 Other analgesic 15 (13.4) 9 (16.4) 0.62
 Inotrope exposure 45 (40.2) 33 (60.0) 0.016
Median mattress temperature by epoch
 0–6 h 33.0 (29.0–35.0) 34.5 (33.8–36.0) <0.0001
 6–24 h 32.0 (30.0–34.5) 33.5 (32.0–36.2) <0.0001
 24–48 h 30.5 (28.0–32.5) 33.0 (31.0–34.5) <0.0001
 48–72 h 32.0 (29.0–34.0) 33.0 (32.0–34.5) 0.002
Organ involvement
 Oliguria/anuria 47 (42.0) 44 (80.0) <0.0001
 Liver dysfunction 69 (61.6) 43 (78.2) 0.038
 DIC 38 (33.9) 31 (56.4) 0.005
 Hypoglycemia 30 (26.8) 20 (36.4) 0.17
 Hypotension 36 (32.1) 26 (47.3) 0.056
 Respiratory support 96 (85.7) 54 (98.2) 0.025
 Total organ involvement score 3 (2–4) 4 (3–5) <0.0001
Sarnat after rewarming
 Mild 72 (66.1) 6 (10.9) <0.0001
 Moderate 34 (31.2) 26 (47.3)
 Severe 3 (2.8) 15 (27.3)
 Missing/Dieda 3 (2.8) 8 (14.5)

Comparison of average mattress temperatures (MT) by epoch of therapeutic hypothermia (TH) as well as evidence of encephalopathy and organ dysfunction by long-term outcome. Infants who died or survived with moderate-severe neurodevelopmental impairment (NDI) were more likely to have severe encephalopathy at randomization, documented seizures, evidence of end-organ dysfunction, a higher likelihood of being exposed to anticonvulsant medications, particularly phenobarbital, as well as morphine and inotropes. Infants who died or survived with NDI also had significantly higher average MTs across all time epochs, though only a trend was seen between survivors at 48–72 h. Bolded values indicate p-value <0.05 compared to the NDI-free survival group after adjustment for duration of cooling, where those that survived with NDI or died were considered as separate factors within the same regression models. Binary outcomes were compared with generalized estimated equations (GEE) logistic regression, and continuous outcomes by GEE linear regression. All comparisons are unadjusted except for TH treatment duration.

aSarnat exam was not documented after rewarming in 11 infants: 3 without NDI, 2 with NDI, and 5 who died. MT: mattress temperature; IQR: interquartile range; NDI: neurodevelopmental impairment; ALT: alanine aminotransferase; AST: aspartate aminotransferase; DIC: disseminated intravascular coagulopathy.