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Hypothermia for the treatment of infants with hypoxic–ischemic encephalopathy

Journal of Perinatology volume 30, pages S82–S87 (2010)Cite this article

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Abstract

Neonatal encephalopathy affects 2 to 5 of every 1000 live births and represents a major cause of mortality and long-term morbidity in affected infants. Hypoxic ischemic encephalopathy (HIE) is the major cause of encephalopathy in the neonatal period. Until recently, management of a newborn with encephalopathy has consisted largely of supportive care to restore and maintain cerebral perfusion, provide adequate gas exchange and treat seizure activity. Recent randomized controlled trials have shown that mild therapeutic hypothermia (cooling) initiated within 6 h of birth reduces death and disability in these infants. Cooling can be accomplished through whole-body cooling or selective head cooling. Meta-analysis of these trials suggests that for every six or seven infants with moderate to severe HIE who are treated with mild hypothermia, there will be one fewer infant who dies or has significant neurodevelopmental disability. In response to this evidence, major policy makers and guideline developers have recommended that cooling therapy be offered to infants with moderate to severe HIE. The dissemination of this new therapy will require improved identification of infants with HIE and regional commitment to allow these infants to be cared for in a timely manner.

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Authors and Affiliations

  1. Division of Neonatal–Perinatal Medicine, College of Medicine, University of Vermont College of Medicine, Burlington, VT, USA

    R H Pfister & R F Soll

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  1. R H Pfister
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Correspondence to R H Pfister.

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This paper resulted from the Evidence vs Experience in Neonatal Practices conference, 19 to 20 June 2009, sponsored by Dey, LP.

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Pfister, R., Soll, R. Hypothermia for the treatment of infants with hypoxic–ischemic encephalopathy. J Perinatol 30 (Suppl 1), S82–S87 (2010). https://doi.org/10.1038/jp.2010.91

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