Document Detail


Whole-body cooling after perinatal asphyxia: a pilot study in term neonates.
MedLine Citation:
PMID:  12553298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to test the practicability and safety of whole-body cooling in term neonates with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE) and to report outcomes, a prospective pilot study was carried out in 25 term infants (median postmenstrual age 38 weeks, range 36 to 41 weeks; 20 males, five females). Whole-body cooling, to a target core temperature of 33 to 34 degrees C, started within 6 hours of birth and was maintained for 72 hours. Of the 25 newborn infants (19 Sarnat II and six Sarnat III, 18 outborn), 18 survived, including 13 (72%) with normal cerebral signal by MRI. Temperature instability occurred during cooling in 15 infants, but neither severe haemodynamic instability nor renal failure was seen. Thrombocytopenia developed in 12 infants, including seven with biological disseminated intravascular coagulation. One patient had hypoxaemia with right-to-left shunting through the ductus arteriosus, and seven had limited meningeal or subdural bleeding. Whole-body cooling is feasible in term neonates, with no life-threatening adverse events. Improvements are needed to obtain stable hypothermia for 72 hours.
Authors:
Thierry Debillon; Patrick Daoud; Philippe Durand; Sylvain Cantagrel; Philippe Jouvet; Carole Saizou; Véronique Zupan
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study    
Journal Detail:
Title:  Developmental medicine and child neurology     Volume:  45     ISSN:  0012-1622     ISO Abbreviation:  Dev Med Child Neurol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-28     Completed Date:  2003-02-07     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0006761     Medline TA:  Dev Med Child Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  17-23     Citation Subset:  IM    
Affiliation:
Neonatal Intensive Care Unit, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Nantes, 44 093 Nantes 01, France. thierry.debillon@chu-nantes.fr
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MeSH Terms
Descriptor/Qualifier:
Asphyxia Neonatorum / complications,  diagnosis,  mortality,  therapy*
Body Temperature
Disseminated Intravascular Coagulation / complications
Feasibility Studies
Female
France / epidemiology
Hematoma, Subdural / complications
Humans
Hypothermia, Induced / adverse effects,  methods*
Hypoxia-Ischemia, Brain / complications,  diagnosis,  mortality,  therapy*
Infant, Newborn
Male
Pilot Projects
Prospective Studies
Safety
Severity of Illness Index
Subarachnoid Hemorrhage / complications
Survival Analysis
Thrombocytopenia / complications
Time Factors
Treatment Outcome

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


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