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Consensus statement on integral management of the newborn with hypoxic-ischemic encephalopathyNeonatal encephalopathy secondary to birth asphyxia, the hypoxic ischemic encephalopathy, remains a major cause of postnatal death and neurological sequelae worldwide. supportive therapy has been the mainstay of treatment. Recently series of multicenter clinical trials show the benefits of therapeutic hypothermia in this high risk population. The International liaison Committee on Resuscitation (IlCOR) has recommended hypothermia as a standard of care and a beneficial therapy using the protocols followed in large clinical trials. Our objective was to develop a practical guide to be used at a national level in Chile, compatible with published protocols and standardized on an international basis, practical and compatible with the country's situation, and considering an integral management of the asphyxiated neonates, rescue and neuroprotective therapies. In summary, to establish rescue therapies, with the aim objective of support measures that promote cerebral and systemic oxygenation/perfusion, ensuring optimal cellular homeostasis, which are the basis of the rescue measures in asphyxiated neonates. Along with these rescue therapies, the objective is to perform the more beneficial neuroprotective therapy known today, hypothermia. Hypothermia should be conducted in a level 3 Neonatal Intensive Care unit, with multidisciplinary care and standardized protocols and also multidisciplinary follow-up and rehabilitation therapies.

ResumenSe descrioe el crecimiento de 284 nihos de rnuy bojo peso de nocimiento hosta los 2 ahos de edad corregido, segun sj clasif:cacion de peso al nacer, para idenrificar eventuales diferencias en los patrones de crecimiento entre los que eron adecuados y los pequenos para la edad en lo que respectc a peso, lalla y perimetro craneano. En 164 (58%) casos el peso era adecuado (A) y 120 (42%) ercn oequenos (P) para la edad gestocionai [EG], segun las tablas de Juez. Los n:hos AEG se caracterizaron por menor edad gestacional (28,92 ± 1,5 ante 31,86 ± 2,0 semanas, p < 0,05|, requerimientos significactivarnente mas prolongaaos de asistencia de la ventilacion (5,01 ± 9,33 onle 1,73 ± 4,84 dias, p<0,05) y oxigenoterapia (150,2± 21,8 ante 6,72 ± 14,18 dias, p < 0,05) que los PEG. A los 18 meses 5,2% de ~,r,os de peso adecuado y 15,4% de los pequenos tenian puntojes Z -2 de peso en comparacion con la norrno del NCHS. En arnbos grupos el puntaje Z de la recuperacion del peso fue proporcional-me^.te mayor que para !a talla en los primeros 6 meses; posteriormente el peso se hizo concordante con la talla clcanzada. En los ninos pequenos para lo edad de gesracion se registro, ademas, un crecimiento recuperacional precoz del peso y el perimet'-o craneano en los primeros seis meses, nientras el de la talla se extendio hasia despues G6' ano de edod.(Palabras clave: crecimiento, muy bajo peso al nacer.) Growth of adecuate and small for gestational age very low birth weight infantsHe ght, weight and head circumference growth palerns were recorded to 284 very low birth weight infants, 164 ooecucte [AGE) and 120 small (SGE) for gestational age, coming from medium-Sow income families and folloxved up along the first two years of life at Santiago, Chile, in order to identify early hints of future growth and nutritional states, T-e AEG infanrs had lower gestational age (28.92 ±1 .5 vs. 31 .86 ± 2.0 weeks, p< 0.05) and longer time under mechanical ventilation (5.01 ± 9.33 vs. 1.73 ±4,84 days, p < 0.05) and oxygen therapy [1 5.2 ± 21 .8 vs. 6.72 ± 14.18 days, p < 0.05) than SGE. At 18 months of corrected age 5.2% of AGE and 15,4% of SGE infants had Z score for weight unde r -2 by NHCS standards. Both AGE and SGE infants showed higher weight Z scores, out of oropcrtion ro height increase, in the first six posnatal months. Thereafter proportional increases of weight and height Z scores were observed. SGE infants showed a catch up type of growth, which was also earlier (first six months) for weight and cranial circumference than for height, but that still went along all the first year of corrected age for this iate.