Therapeutic moderate hypothermia in newborns with hypoxic-ischemic encephalopathy is rapidly becoming standard clinical practice. We report here 12 cases of subcutaneous fat necrosis among 1239 cases registered with a national registry of newborns treated with moderate whole-body hypothermia. All the infants suffered from perinatal asphyxia and hypoxic-ischemic encephalopathy. Moderate-to-severe hypercalcemia was identified in 8 of 10 infants with blood calcium measurements. In all cases the skin lesions appeared after completion of the cooling treatment. Our data suggest that prolonged moderate hypothermia is an actual risk factor for subcutaneous fat necrosis. Because the lesions often develop several days after birth, physicians need to be aware of this condition as a possible complication in infants treated with moderate hypothermia after asphyxia. Blood calcium levels need to be monitored in affected infants.
Subcutaneous Fat Necrosis After Moderate Therapeutic Hypothermia in Neonates
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
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Brenda Strohm, Anna Hobson, Peter Brocklehurst, A. David Edwards, Denis Azzopardi; on behalf of the UK TOBY Cooling Register, Subcutaneous Fat Necrosis After Moderate Therapeutic Hypothermia in Neonates. Pediatrics August 2011; 128 (2): e450–e452. 10.1542/peds.2010-3508
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