Document Detail


Safety of deep hypothermia in treating neonatal asphyxia.
MedLine Citation:
PMID:  18025795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several studies have demonstrated the efficiency and safety of mild hypothermia (33 degrees C) used for treating moderate encephalopathy. In animal models, deep hypothermia proved to be neuroprotective. OBJECTIVES: To determine the safety of whole-body deep hypothermia between 30 and 33 degrees C in moderate-severe hypoxic-ischemic encephalopathy in newborn term infants. METHODS: Mortality rates, incidence of brain damage detected by magnetic resonance imaging (MRI) and neurological outcomes of 39 term asphyxiated infants were retrospectively compared. A first group of patients (control group C) was treated with routine standard methods, a second group (MH) was treated with mild whole-body hypothermia (32-34 degrees C) and a third group (DH) was treated with deep whole-body hypothermia (30-33 degrees C), for 72 h. Mean arterial pH, basic excess (BE) and lactic acid in the blood were measured. Laboratory and clinical side effects of hypothermia were investigated. A conventional brain MRI was performed after the second week of life. Results: 39 term asphyxiated newborns were enrolled in the study: 11 in group C, 10 in group MH, and 18 in group DH. During the first 72 h, disseminated intravascular coagulation was recorded in 2 cases (18%) in group C, pulmonary hypertension in 2 patients (20%) in group MH, and pneumonia in 3 cases (16%) in group DH. Severe cerebral lesions and poor neurological outcome were observed in 4 cases (36%) in group C, 1 case (10%) in group MH, and 1 case (5%) in group DH. A statistically significant difference in brain damage and major clinical neurological abnormalities was observed between group C and groups MH and DH, whereas no differences were demonstrated between asphyxiated infants treated with mild or deep hypothermia. CONCLUSIONS: The results support the safety of deep hypothermia. Further studies are needed to confirm these results and the neuroprotective effect of this approach.
Authors:
Gilberto Compagnoni; Chiara Bottura; Giacomo Cavallaro; Gloria Cristofori; Gianluca Lista; Fabio Mosca
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Publication Detail:
Type:  Journal Article     Date:  2007-11-16
Journal Detail:
Title:  Neonatology     Volume:  93     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-06-05     Completed Date:  2008-08-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  230-5     Citation Subset:  IM    
Copyright Information:
(c) 2007 S. Karger AG, Basel.
Affiliation:
NICU, Carlo Poma Hospital, Mantova, Italy.
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MeSH Terms
Descriptor/Qualifier:
Asphyxia Neonatorum / mortality,  physiopathology,  therapy*
Body Temperature
Brain / pathology,  physiopathology
Electroencephalography
Gestational Age
Humans
Hypothermia, Induced*
Hypoxia-Ischemia, Brain / etiology,  physiopathology,  prevention & control*
Infant, Newborn
Magnetic Resonance Imaging
Retrospective Studies
Survival Rate
Treatment Outcome

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


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