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Abstract Details

Therapeutic Hypothermia in Neonatal Encephalopathy: Creating a Post-Pandemic Playbook
Child Neurology and Developmental Neurology
P10 - Poster Session 10 (8:00 AM-9:00 AM)
Hypoxic Ischemic Encephalopathy (HIE) is the most common cause of neonatal seizures (Glass et al., 2009). Higher seizure burden is associated with more severe brain injury and worse neurodevelopmental outcomes (Srinivasakumar et al., 2015). During the COVID-19 pandemic, a monumental shift in care delivery diverted resources to focus on patients with COVID-19. While this led to known delays in outpatient and elective EEG studies, many guidelines maintained the necessity for inpatient EEG, particularly for Neonatal Hypoxic Ischemic Encephalopathy.
The aim of this initiative was to look into the impact of the COVID-19 pandemic on inpatient EEG, particularly in neonatal encephalopathy. 
At a tertiary care academic center between March 2020-September 2021, 30 neonates diagnosed with neonatal encephalopathy underwent therapeutic hypothermia (TH). Adherence to institutional TH protocol was defined as continuous EEG (cEEG) within 6 hours of TH initiation with repeat at 12-24 hours of normothermia. Time to cEEG placement was evaluated. 
In this cohort, time to cEEG appeared to positively correlate with overall COVID-19 hospitalization rates in the region. During Summer 2020 (June-September), time to cEEG consistently was below 6 hours, with an average of 3.4 hours. When COVID-19 cases increased in Fall 2020 to Spring 2021 (November-March), time to cEEG drastically increased to an average of 14.2 hours. 

This data shows an increase in the average time to initiation of cEEG in TH was significantly different between these two time periods of the pandemic (p=0.0044). There are likely a number of factors which contribute to these findings, including EEG availability, staff and tech availability, as well as overall hospital resources. We are limited by a small sample size. However, this data illustrates the need for new strategies to maintain optimal patient care during times of limited resources.
Justin Rosati, MD (University of Rochester Medical Center)
Dr. Rosati has nothing to disclose.
Jennifer T. Nguyen, MD (University of Rochester Medical Center) Dr. Nguyen has received research support from Teva Pharmaceuticals LTD.