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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Neonatology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1405731
This article is part of the Research Topic Clinical Trial Design and Development in Neonatal and Perinatal Medicine View all 7 articles

Short-Term Effects of Opioids During Therapeutic Hypothermia for Neonatal Encephalopathy

Provisionally accepted
Tina Jumani Tina Jumani 1*Tonya Robinson Tonya Robinson 2*Jeffrey Shenberger Jeffrey Shenberger 3*Jonathan M. Davis Jonathan M. Davis 4*Benjamin Sweigart Benjamin Sweigart 5*Rodica Turcu Rodica Turcu 6
  • 1 St. Elizabeth's Medical Center, Boston, Massachusetts, United States
  • 2 University of Louisville, Louisville, Colorado, United States
  • 3 Connecticut Children's Medical Center, Hartford, Connecticut, United States
  • 4 Tufts Medical Center, Boston, Massachusetts, United States
  • 5 Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts, United States
  • 6 Massachusetts General Hospital, Harvard Medical School, Boston, United States

The final, formatted version of the article will be published soon.

    Objective: To examine the effects of opioids during therapeutic hypothermia (TH) on short-term outcomes in neonates with neonatal encephalopathy (NE).Methods: Multicenter retrospective study of neonates with moderate/severe NE from Jan. 2013-Feb 2021. Opioid exposure was classified as positive (> 0.1 mg/kg) or negative (no exposure or <0.1 mg/kg) based on cumulative morphine milligram equivalents (MME). Negative binomial regression models were used to evaluate clinical outcomes.Results: One hundred and twenty neonates were included. Adjusted analyses indicated that opioid exposure was associated with an increase in 1) length of hospitalization, 2) hypotension/use of vasopressors, and 3) need for and longer duration of mechanical ventilation.Many findings persisted even after adjusting for site and the presence of confirmed seizures (a marker of disease severity).Discussion: Opioid use during TH was associated with adverse effects on short-term outcomes.Caution should be exercised when using opioids during TH until longer-term neurodevelopmental outcome studies can be conducted in larger cohorts.

    Keywords: encephalopathy, Hypothermia, Opioids, neonate, Outcome, neurodevelopmental

    Received: 23 Mar 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Jumani, Robinson, Shenberger, Davis, Sweigart and Turcu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tina Jumani, St. Elizabeth's Medical Center, Boston, Massachusetts, United States
    Tonya Robinson, University of Louisville, Louisville, 40292, Colorado, United States
    Jeffrey Shenberger, Connecticut Children's Medical Center, Hartford, 06106, Connecticut, United States
    Jonathan M. Davis, Tufts Medical Center, Boston, Massachusetts, United States
    Benjamin Sweigart, Tufts Clinical and Translational Science Institute, Tufts University, Boston, 02111, Massachusetts, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.