Effect of Therapeutic Hypothermia on Renal Parameters in Neonates With Birth Asphyxia

Tara Handattu, Shadab Babasaheb Maldar, Prakash Kottrabasappa Wari, Prakash Muttanna Kabbur

Abstract

Background and Aim: Therapeutic hypothermia (TH) is the preferred treatment for birth asphyxia, as it has been proven to improve neurologic outcomes in neonates. There are only a few studies on the effect of TH on renal functions in the Indian scenario. Hence, we undertook this study to compare renal parameters in neonates treated with TH and those who did not receive TH.

Materials and Methods: This prospective cohort study was conducted in the NICU of Karnataka Institute of Medical Sciences (Hubballi, Karnataka, India), between December 2018 and November 2019. Totally, 80 neonates who fulfilled the inclusion criteria were included in the study and divided into 2 groups: standard treatment only and standard treatment + TH groups. The respective treatments were administered to the neonates. Serum creatinine and electrolyte levels were assessed at postnatal 6, 24, 48, and 72 hours. Urine output was measured in all the neonates, and blood culture test was done to detect sepsis.

Results: There were 44 neonates in the standard treatment + TH group and 36 neonates in the standard treatment only group. The incidence of acute kidney injury (AKI) was seen in 41.9% of the neonates in the standard treatment + TH group and 48.4% of the neonates in the standard treatment only group, and the difference was not statistically significant. Oliguric AKI was noted in 66.7% of the neonates (P < .05) in the overall study population. There was no statistical significance in terms of inotrope requirement, vasopressor requirement, serum electrolyte levels, and mortality between the groups.

Conclusion: The incidence of AKI and serum electrolyte level did not significantly differ between the standard treatment + TH and standard treatment only groups.