Document Detail


Temperature profile and outcomes of neonates undergoing whole body hypothermia for neonatal hypoxic-ischemic encephalopathy.
MedLine Citation:
PMID:  21499182     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Decreases below the target temperature were noted among neonates undergoing cooling in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Trial of whole body hypothermia for neonatal hypoxic-ischemic encephalopathy.
OBJECTIVE: To examine the temperature profile and impact on outcome among ≥ 36 wk gestation neonates randomized at ≤ 6 hrs of age targeting an esophageal temperature of 33.5°C for 72 hrs.
DESIGN, SETTING, PATIENTS: Infants with intermittent temperatures recorded of <32.0°C during induction and maintenance of cooling were compared to all other cooled infants, and the relationship with outcome at 18 months was evaluated.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: There were no differences in the stage of encephalopathy, acidosis, or 10 min Apgar scores between infants with temperatures of <32.0°C during induction (n = 33) or maintenance (n = 10) and all other infants who were cooled (n = 58); however, birth weight was lower and the need for blood pressure support higher among infants with temperatures of <32.0°C compared to all other cooled infants. No increase in acute adverse events was noted among infants with temperatures of <32.0°C, and hours spent at <32°C was not associated with the primary outcome of death or moderate/severe disability or the Bayley II Mental Developmental Index at 18 months.
CONCLUSIONS: Term infants with a lower birth weight are at risk for decreasing temperatures of <32.0°C while undergoing body cooling using a servo-controlled system. This information suggests extra caution during the application of hypothermia as these lower birth weight infants are at risk for overcooling. Our findings may assist in planning additional trials of lower target temperature for neonatal hypoxic-ischemic encephalopathy.
Authors:
Seetha Shankaran; Abbot R Laptook; Scott A McDonald; Rosemary D Higgins; Jon E Tyson; Richard A Ehrenkranz; Abhik Das; Guilherme Sant'Anna; Ronald N Goldberg; Rebecca Bara; Michele C Walsh;
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  13     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-05-09     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Birth Weight*
Body Temperature Regulation / physiology*
Critical Illness / mortality,  therapy
Female
Follow-Up Studies
Humans
Hypothermia, Induced / adverse effects,  methods*
Hypoxia-Ischemia, Brain / diagnosis,  mortality,  therapy*
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Male
Monitoring, Physiologic / methods*
Prospective Studies
Risk Assessment
Survival Rate
Term Birth*
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
U10 HD021385/HD/NICHD NIH HHS; U10 HD021385-26/HD/NICHD NIH HHS; U10 HD21364/HD/NICHD NIH HHS; U10 HD21373/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD21397/HD/NICHD NIH HHS; U10 HD27851/HD/NICHD NIH HHS; U10 HD27853/HD/NICHD NIH HHS; U10 HD27856/HD/NICHD NIH HHS; U10 HD27871/HD/NICHD NIH HHS; U10 HD27880/HD/NICHD NIH HHS; U10 HD27904/HD/NICHD NIH HHS; U10 HD34216/HD/NICHD NIH HHS; U10 HD36790/HD/NICHD NIH HHS; U10 HD40461/HD/NICHD NIH HHS; U10 HD40492/HD/NICHD NIH HHS; U10 HD40498/HD/NICHD NIH HHS
Comments/Corrections

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


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