{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T13:09:16Z","timestamp":1775480956479,"version":"3.50.1"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>\n            Objective\u2003The National Institute of Child Health and Human Development (NICHD) magnetic resonance imaging (MRI) pattern of brain injury is a known biomarker of childhood outcome following therapeutic hypothermia for neonatal hypoxic\u2013ischemic encephalopathy (HIE). However, usefulness of this classification has not been evaluated to predict short-term outcomes. The study aimed to test the hypothesis that infants with NICHD MRI pattern of severe hypoxic\u2013ischemic brain injury will be sicker with more severe asphyxia-induced multiorgan dysfunction resulting in prolonged length of stay (LOS) following therapeutic hypothermia. We also evaluated the role of other risk factors which may prolong LOS.<\/jats:p><jats:p>\n            Study Design\u2003We retrospectively reviewed the medical records of 71 consecutively cooled neonates to examine the ability of MRI patterns of brain injury to predict the LOS. A neuroradiologist masked to outcomes classified the patterns of brain injury on MRI as per NICHD. Pattern 2A (basal ganglia thalamic, internal capsule, or watershed infarction), 2B (2A with cerebral lesions), and 3 (hemispheric devastation) of brain injury was deemed \u201csevere injury.\u201d<\/jats:p><jats:p>\n            Results\u2003Out of 71 infants, 59 surviving infants had both MRI and LOS data. LOS was higher for infants who had Apgar's score of \u22645 at 10\u2009minutes, severe HIE, seizures, coagulopathy, or needed vasopressors or inhaled nitric oxide, or had persistent feeding difficulty, or remained intubated following cooling. However, median LOS did not differ between the infants with and without MRI pattern of severe injury (15 days, interquartile range [IQR]: 9\u201328 vs. 12 days, IQR: 10\u201320; p\u2009=\u20090.4294). On multivariate linear regression analysis, only persistent feeding difficulty (\u03b2 coefficient\u2009=\u200911, p\u2009=\u20090.001; or LOS\u2009=\u200911 days longer if had feeding difficulty) and ventilator days (\u03b2 coefficient 1.7, p\u2009&lt;\u20090.001; or LOS increased 1.7 times for each day of ventilator support) but not the severity of brain injury predicted LOS.<\/jats:p><jats:p>\n            Conclusion\u2003Unlike neurodevelopmental outcome, LOS is not related to severity of brain injury as defined by the NICHD.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1730431","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T02:17:21Z","timestamp":1623205041000},"page":"666-671","source":"Crossref","is-referenced-by-count":8,"title":["Does Severity of Brain Injury on Magnetic Resonance Imaging Predict Short-Term Outcome in Neonates Who Received Therapeutic Hypothermia?"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0768-448X","authenticated-orcid":false,"given":"Indira","family":"Bhagat","sequence":"additional","affiliation":[{"name":"Neonatal-Perinatal Medicine, Children's Hospital of Michigan, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Neonatal-Perinatal Medicine, Children's Hospital of Michigan, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avishek","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Michigan State University, East Lansing, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Dechert","sequence":"additional","affiliation":[{"name":"University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Altinok","sequence":"additional","affiliation":[{"name":"Neonatal-Perinatal Medicine, Children's Hospital of Michigan, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Chouthai","sequence":"additional","affiliation":[{"name":"Neonatal-Perinatal Medicine, Children's Hospital of Michigan, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jpeds.2010.09.003","article-title":"Perinatal events and early magnetic resonance imaging in therapeutic hypothermia","volume":"158","author":"S L Bonifacio","year":"2011","journal-title":"J 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