Document Detail


Whole body cooling in newborn infants with perinatal asphyxial encephalopathy in a low resource setting: a feasibility trial.
MedLine Citation:
PMID:  21169643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the feasibility and safety of whole body cooling in newborn infants with perinatal asphyxial encephalopathy in a low resource setting.
DESIGN: Feasibility trial.
SETTING: Tertiary care perinatal centre.
SUBJECTS: Infants born at > 35 weeks gestation with perinatal asphyxia were included in the study.
INTERVENTIONS: Infants were cooled to a rectal temperature of 33 ± 0.5°C for 72 hours using cloth-covered ice-gel packs. Vital parameters were monitored continuously.
OUTCOME MEASURES: The primary outcome was the achievement of target temperature within 1 hour of initiation of treatment and maintaining the target temperature for 72 hours. Adverse events and possible complications of hypothermia were the secondary outcomes measured.
RESULTS: Twenty infants were included in the study. The mean time taken to achieve target rectal temperature was 52 ± 25 minutes. The mean rectal temperature during cooling was 32.9 ± 0.11ºC. The target temperature could be maintained for 72 hours without difficulty in all babies. Adverse events observed during cooling were thrombocytopenia (25%), sinus bradycardia (25%), deranged bleeding parameters (20%), aposteatonecrosis (15%), hyperglycemia (15%), hypoglycemia (10%), hypoxemia (5%), life-threatening coagulopathy (5%) and death (5%). Shivering was noted in many of the babies, especially in the initial phase of cooling.
CONCLUSION: Whole body cooling in term infants with perinatal asphyxia is achievable, safe and inexpensive in a low-resource setting.
Authors:
Niranjan Thomas; Koshy C George; Santhanam Sridhar; Manish Kumar; Kurien Anil Kuruvilla; Atanu Kumar Jana
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-30
Journal Detail:
Title:  Indian pediatrics     Volume:  48     ISSN:  0974-7559     ISO Abbreviation:  Indian Pediatr     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-07-11     Completed Date:  2011-11-09     Revised Date:  2012-03-14    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  445-51     Citation Subset:  IM    
Affiliation:
Neonatology Unit, Christian Medical College Hospital, Vellore, India. niranjan@cmcvellore.ac.in
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MeSH Terms
Descriptor/Qualifier:
Asphyxia Neonatorum / therapy*
Brain / physiology
Developing Countries
Feasibility Studies
Female
Humans
Hyperthermia, Induced / economics,  methods*
Hypoxia, Brain / therapy*
India
Infant, Newborn
Intensive Care, Neonatal / economics,  methods*
Male
Comments/Corrections
Comment In:
Indian Pediatr. 2012 Jan;49(1):74-5; author reply 75-6   [PMID:  22318114 ]
Indian Pediatr. 2011 Jun;48(6):441-2   [PMID:  21743110 ]

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