Pediatric Resident University of Hawaii, John A. Burns School of Medicine Honolulu, Hawaii, United States
Background: The outcomes of Hypoxic Ischemic Encephalopathy (HIE) vary widely from normal development to devastating consequences. Current assessments like MRI and EEG predict neurodevelopment (ND) outcomes in HIE infants, but lack functional ability to provide holistic evaluations. Early functional prognostic tools to predict ND outcomes after hospital discharge are limited. After therapeutic hypothermia, infants are transitioned from enteral-tube to oral feeds. The inability to feed orally (PO) due to dysphagia may reflect neurological impairment caused by HIE. Functional Oral Intake Scale (FOIS) scores are used to assess oropharyngeal dysphagia in adults following an acute stroke. However, this scoring system still needs to be investigated in infants. In this study, infant functional feeding quality will be determined using a modified FOIS (mFOIS) based on presence of dysphagia, PO intake volume, and assistance needs. Objective: This study investigates feeding functionality, using mFOIS, as a predictive measure of ND outcomes when compared to Battelle Developmental Inventory (BDI-2) in infants with mild, moderate, and severe HIE. Design/Methods: This is a retrospective, IRB-exempt, study of infants diagnosed with HIE, born at > 35 weeks GA, birthweight >1800g, admitted to KMCWC NICU from 2019-2021. Infants with major congenital anomalies or deceased prior to discharge were excluded. Maternal risk factors, infant demographics, comorbidities, clinical data, MRI results, and BDI-2 scores were collected. The mFOIS scale is defined as level 1: nothing by mouth, 2: < 25% PO with dysphagia, 3: 25-75% PO with tube dependence (TD), 4: >75% PO with TD, 5: full PO with assistance, 6: full PO without assistance. Risk factors, mFOIS and BDI-2 scores will be compared for infants with mild, moderate and severe HIE based on SARNAT. One-way analysis of variance with multiple comparisons will be performed for continuous variable data. Chi-square will be used for categorical data analysis. Currently in data collection. Statistical analysis and final poster are expected to be completed by 3/2024.
