Document Detail


Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit.
MedLine Citation:
PMID:  16407967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to determine the efficacy of mild hypothermia via selective head cooling as a neuroprotective therapy in term infants with perinatal asphyxia. STUDY DESIGN: Full-term newborns who had 5 min Apgar scores <6, first arterial blood gas pH<7.10 or BD>15 mEq/l, and with the clinical signs of encephalopathy were enrolled within 6 h after birth. Patients were randomized to receive mild hypothermia treatment via selective head cooling for a total of 72 h or receive routine treatment as a control. Brain hypoxic-ischemic injury was quantified based on the head computed tomographic scan (CT scan) at postnatal age 5-7 days and a Neonatal Behavioral Neurological Assessment (NBNA) score at 7-10 days of life. RESULTS: A total of 58 patients (30 hypothermia, 28 control) completed the study. Hypothermia was well tolerated in this study and attenuated the hypoxic-ischemic brain injury due to perinatal asphyxia. Head CT scan demonstrated moderate to severe hypoxic-ischemic changes in only 4/30 cases from the hypothermic group. In contrast, 18/28 cases in the control group showed moderate to severe hypoxic-ischemic changes (chi (2)=15.97, P<0.01). Brain hypothermia also significantly improved the NBNA score (32+/-2 in the hypothermic group vs 28+/-3 in the control group, P<0.01). CONCLUSIONS: Our results suggest that selective head cooling may be used as a neuroprotective therapy in term neonates with perinatal asphyxia. A long-term follow-up study is needed to further validate the results of this study.
Authors:
Z-L Lin; H-M Yu; J Lin; S-Q Chen; Z-Q Liang; Z-Y Zhang
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  26     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-22     Completed Date:  2006-06-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-4     Citation Subset:  IM    
Affiliation:
Department of Neonatology, Yuying Children's Hospital of Wenzhou Medical College, Wenzhou, China. linzhenlang@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Apgar Score
Asphyxia Neonatorum / diagnosis*,  therapy*
Case-Control Studies
Female
Follow-Up Studies
Gestational Age
Humans
Hypothermia, Induced / methods*
Hypoxia, Brain / prevention & control*
Infant, Newborn
Intensive Care Units, Neonatal
Male
Pregnancy
Reference Values
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Survival Rate
Treatment Outcome
Comments/Corrections
Comment In:
J Perinatol. 2006 Mar;26(3):144-6   [PMID:  16493431 ]

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


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