Article Text

Download PDFPDF

Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy
  1. P Shah1,
  2. S Riphagen2,
  3. J Beyene1,
  4. M Perlman2
  1. 1Department of Paediatrics, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
  2. 2Division of Neonatology, Hospital for Sick Children, Toronto, and Department of Paediatrics, University of Toronto
  1. Correspondence to:
    Dr Shah
    Room 775A, Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5;


Background: Multiorgan dysfunction (MOD) is one of four consensus based criteria for the diagnosis of intrapartum asphyxia. The theoretical concept behind MOD is the diving reflex (conservation of blood flow to vital organs at the cost of non-vital organs).

Objectives: To assess the patterns of involvement of each major organ/system and combinations of involvement in infants with post-asphyxial hypoxic-ischaemic encephalopathy (HIE), and to describe this in relation to long term outcome.

Design: Retrospective cohort study.

Setting: Regional tertiary neonatal intensive care unit at the Hospital for Sick Children, Toronto, Canada.

Patients: Term neonates with post-intrapartal asphyxial HIE assessed for kidney, cardiovascular system, lung, and liver function.

Outcome: Death and presence or absence of severe neurodevelopmental disability.

Results: Out of 130 of 144 eligible infants with outcome data, 80 (62%) had severe adverse outcome and 50 (38%) had good outcome. All infants had evidence of MOD (at least one organ dysfunction in addition to HIE). Renal, cardiovascular, pulmonary, and hepatic dysfunction was present in 58–88% of infants with good outcome and 64–86% of infants with adverse outcome.

Conclusions: MOD was present in all the infants with severe post-asphyxial HIE. However, there was no association between MOD and outcome in these infants. No relation between individual or combinations of organ involvements and long term outcomes was observed.

  • asphyxia
  • diving reflex
  • organ dysfunction
  • HIE, hypoxic-ischaemic encephalopathy
  • MOD, multiorgan dysfunction
View Full Text

Statistics from


    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.