Hypothermia for newborns with hypoxic-ischemic encephalopathy

January 01, 0001

Hypothermia for newborns with hypoxic-ischemic encephalopathy

These investigators from multiple countries conducted a randomized controlled trial to determine the effectiveness and safety of moderate whole-body hypothermia (33.5°C for 72 hours) in newborns with hypoxic- ischemic encephalopathy born in hospitals with and without newborn intensive care facilities or complicated hypothermia equipment. They included newborns of 35 weeks' gestation or more, with indicators of peripartum hypoxia-ischemia and moderate to severe clinical encephalopathy, randomly allocated to hypothermia (n = 110) or standard care (n = 111).

They found: "Therapeutic hypothermia reduced the risk of death or major sensorineural disability at 2 years of age: 55 of 107 infants (51.4%) in the hypothermia group and 67 of 101 infants (66.3%) in the control group died or had a major sensorineural disability at 2 years (risk ratio, 0.77). The mortality rate decreased, and the survival rate free of any sensorineural disability increased. Adverse effects of hypothermia were minimal."

The authors concluded: "Whole-body hypothermia is effective and appears to be safe when commenced within 6 hours of birth at the hospital of birth in term and near-term newborns with hypoxic-ischemic encephalopathy. This simple method of hypothermia could be used within strict protocols with appropriate training on correct diagnosis and application of hypothermia in nontertiary neonatal settings while awaiting retrieval and transport to the regional neonatal intensive care unit."

This study establishes the value of hypothermia for the prevention of secuelae of hypoxic-ischemic encephalopathy at birth.

For the full abstract, click here.

Arch Pediatr Adolesc Med 165(8):692-700, August 2011 © 2011 to the American Medical Associaiton
Whole-Body Hypothermia for Term and Near-Term Newborns With Hypoxic-Ischemic Encephalopathy-A Randomized Controlled Trial. Susan E. Jacobs, Colin J. Morley, Terrie E. Inder, et al. Correspondence to Dr. Jacobs: [email protected]

Category: N. Neurological. Keywords: hypothermia, hypoxic-ischemic encephalopathy, newborn, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 19 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.