Hypoxic-ischemic encephalopathy (HIE) is associated with high rates of morbidity and mortality, and only recently has an effective treatment been developed to mitigate its sequelae. Moderate therapeutic hypothermia (TH) (core temperatures of 33oC–35oC) has been found in a number of randomized clinical trials to reduce mortality and improve neurodevelopmental outcomes in full-term neonates with moderate or severe HIE. TH can be administered using various techniques, but optimal use dictates meticulous control of targeted core temperature (usually assessed as rectal temperature), and thus servo-controlled devices have an advantage. Treatment is applied for 72 hours, and then gradual rewarming is performed at a slow rate. Rapid rewarming and hyperthermia should be avoided because they may be associated with neuronal damage and reversal of the benefits of TH. Long-term outcomes, at ages 6 to 8 years, correlate well with the benefits observed at 18- to 24-month follow-up. Although better than any alternative therapy currently available, the rates of mortality and morbidity still remain high even when using TH.
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July 2015
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July 01 2015
Treating Hypoxic Ischemic Encephalopathy With Hypothermia Available to Purchase
Jose M. R. Perez, MD;
Jose M. R. Perez, MD
*SIBEN - Ibero-American Society of Neonatology, International Neurodevelopment Neonatal Center, São Paulo, Brazil.
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Alexander Feldman, DO;
Alexander Feldman, DO
†The Regional Neonatal Center, Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY.
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Gad Alpan, MD, MBA
Gad Alpan, MD, MBA
†The Regional Neonatal Center, Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY.
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Author Disclosure
Dr Perez has disclosed that he holds a patent for the Neonatal Laminar Flow Unit. Drs Feldman and Alpan disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.
Neoreviews (2015) 16 (7): e413–e419.
Citation
Jose M. R. Perez, Alexander Feldman, Gad Alpan; Treating Hypoxic Ischemic Encephalopathy With Hypothermia. Neoreviews July 2015; 16 (7): e413–e419. https://doi.org/10.1542/neo.16-7-e413
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