Clinical manifestations and interrelations of multidisciplinary referral with neonatal hypoxic-ischemic encephalopathy

Luíza Silva Vernier, Chenia Caldera Martinez, Daniel Marchand, Janice Lukrafka, Ernani Miura and Deisi Cristina Gollo Marques Vidor

Objective: To investigate clinical characteristics, complications, and neonatal conditions of Neonatal Hypoxic-Ischemic Encephalopathy patients and their relation with necessity of a multidisciplinary approach.
Methods: Cross-sectional study using data collected from medical records of Neonatal Hypoxic-Ischemic Encephalopathy children, aged from 0 to 24 months, seen in the last five years in a hospital in southern Brazil. Analysis of birth data, clinical intercurrences, and neonatal conditions of these patients were done while attempting to relate them to the need for multidisciplinary follow-up.
Results: Of 208 medical records collected, 111(53.36%) were of boys. Of all patients, 76(47.79%) had vaginal birth, mean gestational age was 34.86 weeks (SD±4.30), mean birth weight was 2,392.31g (SD±973.618), mean Apgar score in the first and fifth minutes was 5.25 and 7.18, respectively and 116(60.19%) were preterm. Regarding multidisciplinary referral, seven (8.17%) were referred to Speech Therapy and 86(41.34%), to Physiotherapy, with significant association of these referrals with the variables pre-term birthsss, sepsis, and ventilator support (p≤0.05). The convulsion event variable was related only to Speech Therapy referral (p=0.005) and respiratory distress, only to Physiotherapy referral (p=0.008). The Oral Motor Sensory System variable was also analyzed and a relationship with respiratory distress, sepsis, and ventilator support was observed (p<0.05). Conclusion: These patients have traits that lead to rehabilitation due to specific characteristics of their neurological condition, requiring multidisciplinary referrals, including Physiotherapy and Speech Therapy interventions. Specific clinical variables of Speech Therapy were significantly related to the clinical manifestations most commonly altered in the sample. Further research is suggested in this area.

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