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Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit

Journal of Perinatology volume 26, pages 180–184 (2006)Cite this article

Abstract

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 (χ2=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).

Conclusion

s: 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.

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Abbreviations

HIE:

hypoxic-ischemic encephalopathy

T NP :

nasopharyngeal temperature

T R :

rectal temperature

CT scan:

computed tomographic scan

NBNA:

Neonatal Behavioral Neurological Assessment

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Acknowledgements

We wish to thank the entire staff members of the NICU of Yuying Children's Hospital of Wenzhou Medical College for helping to complete the study and Drs Sidhartha Tan and Ian Holzman for the critical review and comments of the manuscript.

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Authors and Affiliations

  1. Department of Neonatology, Yuying Children's Hospital of Wenzhou Medical College, Wenzhou, China

    Z-L Lin, S-Q Chen, Z-Q Liang & Z-Y Zhang

  2. Department of Pediatrics, Zhejiang University School of Medical, Hangzhou, China

    H-M Yu

  3. Department of Pediatrics, Mount Sinai School of Medicine, New York, USA

    J Lin

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  1. Z-L Lin
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Correspondence to Z-L Lin.

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Lin, ZL., Yu, HM., Lin, J. et al. Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit. J Perinatol 26, 180–184 (2006). https://doi.org/10.1038/sj.jp.7211412

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