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J Pediatr. 2011 Feb;158(2 Suppl):e51-4. doi: 10.1016/j.jpeds.2010.11.014.

Hypoxic-ischemic encephalopathy: challenges in outcome and prediction.

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Department of Pediatrics, University of Toronto, Toronto, Canada.


The outcomes of hypoxic-ischemic encephalopathy vary between death and intact survival. The spectrum of long-term morbidity in survivors ranges from mild motor and cognitive deficits to cerebral palsy and severe cognitive deficits. Our literature review reinforces the notion that the spectrum of hypoxic-ischemic encephalopathy outcomes represents a continuum, which has important implications for the prediction of outcome and the indications for intervention. We summarize predictive criteria at 3 time points: the first 6 hours of life, 6-72 hours of life, and at hospital discharge. In this era of neuroprotection, predictive models that aid therapeutic decision making, including the withdrawal of support, need to be revised.

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