Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2015

Open Access 01-12-2015 | Research article

Subcutaneous fat necrosis in neonates with hypoxic ischaemic encephalopathy registered in the Swiss National Asphyxia and Cooling Register

Authors: Beate Grass, Lisa Weibel, Cornelia Hagmann, Barbara Brotschi, on behalf of the National Asphyxia and Cooling Register Group

Published in: BMC Pediatrics | Issue 1/2015

Login to get access

Abstract

Background

Neonates with hypoxic ischaemic encephalopathy (HIE) are routinely treated with therapeutic hypothermia (TH) for 72 h in order to improve neurological outcome. Subcutaneous fat necrosis (SCFN) is an adverse event occurring in neonates with HIE.

Methods

We analyzed risk factors for SCFN regarding demographic factors, cooling methods and deviation from target temperature range during hypothermia therapy. Data of all neonates registered in the National Asphyxia and Cooling Register in Switzerland between 2011 and 2013 were analyzed.

Results

2.8 % of all cooled neonates with HIE developed SCFN. Perinatal and neonatal characteristics did not differ between neonates with and without SCFN. Applied cooling methods did not correlate with the occurrence of SCFN. In neonates with SCFN 83.3 % of all noted temperatures were within the target temperature range versus 77.5 % in neonates without SCFN. Neonates with SCFN showed 3.6 % of all measured temperatures below target temperature range compared to 12.7 % in neonates without SCFN.

Conclusion

Subcutaneous fat necrosis in the neonate with HIE undergoing TH is a potential adverse event that seems to occur independently from the whole-body cooling method applied and proportion of temperature measurements outside target temperature range. In this cohort, moderate overcooling associated with moderate hypothermia (33.0–34.0 °C) does not seem to be an independent risk factor for SCFN. There is no correlation between the severity of HIE and incidence of SCFN.
Appendix
Available only for authorised users
Literature
1.
Shankaran S, Laptook A, Ehrenkranz R, Tyson J, Donovan E. Whole-body hypothermia for neonates with hypoxic–ischemic encephalopathy. N Engl J Med. 2005;353(15):1574–84.CrossRefPubMed
2.
Azzopardi D, Strohm B, Marlow N, Brocklehurst B, Deierl A, Eddama O, et al. Effects of hypothermia for perinatal asphyxia on childhood outcomes. N Engl J Med. 2014;371(2):140–9.CrossRefPubMed
3.
Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database of Syst Rev. 2013;1:CD003311.
4.
Tagin MA, Woolcott CG, Vincer MJ, Whyte RK, Stinson DA. Hypothermia for neonatal hypoxic ischemic encephalopathy: an updated systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2012;166(6):558–66.CrossRefPubMed
5.
Azzopardi DV, Strohm B, Edwards AD, Dyet L, Halliday HL, Juszczak E, et al. Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med. 2009;361(14):1349–58.CrossRefPubMed
6.
Strohm B, Hobson A, Brocklehurst P, Edwards AD, Azzopardi D, UK TOBY Cooling Register. Subcutaneous fat necrosis after moderate therapeutic hypothermia in neonates. Pediatrics. 2011;128(2):e450–452.CrossRefPubMed
7.
Mahé E, Girszyn N, Hadj-Rabia S, Bodemer C, Hamel-Teillac D, De Prost Y. Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children. Br J Dermatol. 2007;156(4):709–15.CrossRefPubMed
8.
Burden AD, Krafchik BR. Subcutaneous fat necrosis of the newborn: a review of 11 cases. Pediatric Dermatol. 1999;16(5):384–7.CrossRef
9.
Filippi L, Catarzi S, Padrini L, Fiorini P, la Marca G, Guerrini R, et al. Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia. J Matern Fetal Neonatal Med. 2012;25(10):2115–21.CrossRefPubMed
10.
Oza V, Treat J, Cook N, Tetzlaff MT, Yan A. Subcutaneous fat necrosis as a complication of whole-body cooling for birth asphyxia. Arch Dermatol. 2010;146(8):882–5.CrossRefPubMed
11.
Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696–705.CrossRefPubMed
12.
Thompson CM, Puterman AS, Linley LL, Hann FM, van der Elst CW, Molteno CD, et al. The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome. Acta Pediatr. 1997;86(7):757–61.CrossRef
13.
Hogeling M, Meddles K, Berk DR, Bruckner AL, Shimotake TK, Cohen RS, et al. Extensive Subcutaneous Fat Necrosis of the Newborn Associated with Therapeutic Hypothermia. Pediatr Dermatol. 2012;29(1):59–63.CrossRefPubMed
14.
Calisici E, Oncel MY, Degirmencioglu, Sandal G, Canpolat FE, Erdeve O, et al. A neonate with subcutaneous fat necrosis after passive cooling: does polycythemia have an effect? Case Rep Pediatr. 2013;2013:254089. doi:10.​1155/​2013/​254089.PubMedPubMedCentral
15.
Atherton DJ, Gennery AR, Cant AJ. The Neonate. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s Textbook of Dermatology. Massachusetts, USA: Blackwell; 2004.
16.
Kuboi T, Kusaka T, Okazaki K, Kaku U, Kakinuma R, Kondo M, et al. Subcutaneous fat necrosis after selective head cooling in an infant. Pediatr Int. 2013;55(2):e23–4.CrossRefPubMed
17.
Woods AG, Cederholm CK. Subcutaneous fat necrosis and whole-body cooling therapy for neonatal encephalopathy. Adv Neonatal Care. 2012;12(6):345–8.PubMed
18.
Zifman E, Mouler M, Eliakim A, Nemet D, Pomeranz A. Subcutaneous fat necrosis and hypercalcemia following therapeutic hypothermia—a patient report and review of the literature. J Pediatr Endocrinol Metab. 2010;23(11):1185–8.CrossRefPubMed
19.
Ghergherehchi R. Complication of subcutaneous fat necrosis of the newborn: a case report and review of the literature research. J Biol Sci. 2008;3(9):1004–7.
20.
Aucharaz KS, Baker EL, Millman GC, Ball RJ. Neonatal subcutaneous fat necrosis with characteristic rash and hypercalcaemia. Arch Dis Child Fetal Neonatal Ed. 2007;92(4):F304.CrossRefPubMedPubMedCentral
21.
Tran JT, Sheth AP. Complications of subcutaneous fat necrosis of the newborn: a case report and review of the literature. Pediatr Dermatol. 2003;20(3):257–61.CrossRefPubMed
22.
Wiadrowski TP, Marshman G. Subcutaneous fat necrosis of the newborn following hypothermia and complicated by pain and hypercalcemia. Australas J Dermatol. 2001;42(3):207–10.CrossRefPubMed
23.
Duhn R, Schoen EJ, Siu M. Subcutaneous fat necrosis with extensive calcification after hypothermia in two newborn infants. Pediatrics. 1968;41(3):661–4.PubMed
Metadata
Title
Subcutaneous fat necrosis in neonates with hypoxic ischaemic encephalopathy registered in the Swiss National Asphyxia and Cooling Register
Authors
Beate Grass
Lisa Weibel
Cornelia Hagmann
Barbara Brotschi
on behalf of the National Asphyxia and Cooling Register Group
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2015
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-015-0395-7

Other articles of this Issue 1/2015

BMC Pediatrics 1/2015 Go to the issue

Research article

A prospective study of maternal preference for indomethacin prophylaxis versus symptomatic treatment of a patent ductus arteriosus in preterm infants

Research article

A randomized controlled trial of hospital versus home based therapy with oral amoxicillin for severe pneumonia in children aged 3 – 59 months: The IndiaCLEN Severe Pneumonia Oral Therapy (ISPOT) Study

Research article

Factors associated with red blood cell transfusions in very-low-birth-weight preterm infants in Brazilian neonatal units

Research article

Fever phobia: a comparison survey between caregivers in the inpatient ward and caregivers at the outpatient department in a children’s hospital in China

Research article

Effects of low birth weight on time to BCG vaccination in an urban poor settlement in Nairobi, Kenya: an observational cohort study

Research article

Prospective associations of appetitive traits at 3 and 12 months of age with body mass index and weight gain in the first 2 years of life