Document Detail

Ethical and practical issues relating to the global use of therapeutic hypothermia for perinatal asphyxial encephalopathy.
MedLine Citation:
PMID:  21068075     Owner:  NLM     Status:  MEDLINE    
In intensive care settings in the developed world, therapeutic hypothermia is established as a therapy for term infants with moderate to severe neonatal encephalopathy due to perinatal asphyxia. Several preclinical, pilot and clinical trials conducted in such settings over the last decade have demonstrated that this therapy is safe and effective. The greatest burden of birth asphyxia falls, however, in low- and middle-income countries; it is still unclear whether therapeutic hypothermia is safe and effective in this context. In this paper, the issues around treatments that may be proven safe and effective in the developed world and the caution needed in translating these into different settings and populations are explored. It is argued that there are strong scientific and ethical reasons supporting the conduct of rigorous, randomised controlled trials of therapeutic hypothermia in middle-income settings. There also needs to be substantial and sustainable improvements in all facets of antenatal care and in the basic level of newborn resuscitation in low income countries. This will reduce the burden of disease and allow health workers to determine rapidly which infants are most eligible for potential neuroprotection.
D J Wilkinson; S Thayyil; N J Robertson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-10
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  96     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-23     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F75-8     Citation Subset:  AIM; IM    
The Ethox Centre, Department of Public Health and Primary Health Care, The University of Oxford, Headington, Oxford, UK.
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MeSH Terms
Asphyxia Neonatorum / complications
Developing Countries*
Developmental Disabilities / prevention & control
Ethics, Medical
Hypothermia, Induced / ethics*
Hypoxia-Ischemia, Brain / etiology,  therapy*
Infant, Newborn
Perinatal Care / ethics*,  methods
Translational Research
Grant Support
//Department of Health

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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