Neonatal encephalopathy multiorgan scoring systems: systematic review

Neonatal encephalopathy multiorgan scoring systems: systematic review

Neonatal encephalopathy (NE) is a condition with multifactorial etiology that causes multiorgan injury to neonates. The severity of multiorgan dysfunction (MOD) in NE varies, with therapeutic hypothermia (TH) as the standard of care. The aim is to identify current approaches used to assess and deter...

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Published in:Frontiers in pediatrics Vol. 12; p. 1427516
Main Authors: Razif, Noor Adeebah Mohamed, D'Arcy, Aidan, Waicus, Sarah, Agostinis, Alyssa, Scheepers, Rachelle, Buttle, Yvonne, Pepper, Aidan, Hughes, Aisling, Fouda, Basem, Matreja, Panya, MacInnis, Emily, O'Dea, Mary, Isweisi, Eman, Stewart, Philip, Branagan, Aoife, Roche, Edna F, Meehan, Judith, Molloy, Eleanor J
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media S.A 01-10-2024
Subjects:
brain injury
multiorgan dysfunction score
neonatal encephalopathy
Pediatrics
scoring system
therapeutic hypothermia
brain injury
multiorgan dysfunction score
therapeutic hypothermia
neonatal encephalopathy
scoring system
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Summary:Neonatal encephalopathy (NE) is a condition with multifactorial etiology that causes multiorgan injury to neonates. The severity of multiorgan dysfunction (MOD) in NE varies, with therapeutic hypothermia (TH) as the standard of care. The aim is to identify current approaches used to assess and determine an optimum scoring system for MOD in NE. The systematic review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search was conducted using PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, and CINAHL for studies of scoring systems for MOD in NE. The search yielded 628 articles of which 12 studies were included for data extraction and analysis. Five studies found a positive correlation between the severity of NE and MOD. There was significant heterogeneity across the scoring systems, including the eligibility criteria for participants, the methods assessing specific organ systems, the length of follow-up, and adverse outcomes. The neurological, hepatic, cardiovascular, respiratory, hematological, and renal systems were included in most studies while the gastrointestinal system was only in three studies. The definitions for hepatic, renal, and respiratory systems dysfunction were most consistent while the cardiovascular system varied the most. A NE multiorgan scoring system should ideally include the renal, hepatic, respiratory, neurological, hematological, and cardiovascular systems. Despite the heterogeneity between the studies, these provide potential candidates for the standardization of MOD scoring systems in NE. Validation is needed for the parameters with adequate length of follow-up beyond the neonatal period. Additionally, the evaluation of MOD may be affected by TH considering its multiorgan effects.
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Reviewed by: Mark Steven Scher, Case Western Reserve University, United States
Edited by: Lina Chalak, University of Texas Southwestern Medical Center, United States
Hemmen Sabir, University Hospital Bonn, Germany
ISSN:2296-2360
2296-2360
DOI:10.3389/fped.2024.1427516