MONTREAL, June 17, 2025 – Each year, some babies experience a lack of oxygen before or during birth, which can lead to brain injury—a medical condition known as hypoxic-ischemic encephalopathy (HIE). To date, therapeutic hypothermia remains the only approach proven effective in limiting the neurological damage caused by this oxygen deprivation. However, even with this treatment, the prognosis remains uncertain. One of the main current challenges is to quickly assess the extent of brain injury in order to anticipate the risk of long-term complications or, conversely, the potential for full recovery. This evaluation typically relies on magnetic resonance imaging (MRI), performed after the treatment ends—around the fifth day of life—and requires transporting the fragile newborn out of the intensive care unit. A recent study led by Prof. Mathieu Dehaes and Dr. Elana Pinchefsky, from the Centre de recherche Azrieli du CHU Sainte-Justine and the Université de Montréal, reveals that a combined approach using advanced neuromonitoring techniques can more rapidly predict short-term clinical outcomes of these patients, based on quantitave data—without interfering with their treatment.

To achieve these results, the research team monitored 52 babies treated with therapeutic hypothermia in the neonatal intensive care unit at CHU Sainte-Justine using two complementary technologies: electroencephalography (EEG), which is widely used to record the brain’s electrical activity, and an optical neuromonitoring system (NIRS), capable of measuring several indicators of brain oxygenation and metabolism. These non-invasive tools can be used directly at the bedside, avoiding any need for transport—a crucial advantage given the fragility of these patients.

These measurements allowed the team to accurately identify the severity of the babies’ brain injuries as early as the second day of treatment. “Currently, magnetic resonance imaging (MRI) remains the gold standard for assessing long-term outcomes. It helps differentiate between normal or mild cases and severe ones, but it is typically performed around five days after birth,” explains Mathieu Dehaes. “The integrated approach we propose provides data much more quickly and for all levels of severity.” In fact, by adding cerebral metabolism analysis, the team showed it is now possible to distinguish moderate cases from normal or mild ones, which used to be a major clinical challenge.

Thanks to a collaborative effort that also included Dr. Anne Monique Nuyt and Dr. Ramy El-Jalbout from CHU Sainte-Justine, these promising findings mark a significant step forward in optimizing neonatal care protocols. “In neonatal intensive care, earlier intervention is always better,” says Rasheda Arman Chowdury, former postdoctoral fellow at the Centre de recherche Azrieli du CHU Sainte-Justine and first author of the study. “The accessible techniques we tested offer doctors and medical staff quantitative bedside indicators to identify newborns at risk of moderate or severe complications, thus supporting their clinical decision-making.”