Hypothermia.
Experimental studies show that, following hypoxic ischaemic injury, mild induced hypothermia-a reduction of body temperature by about 3 degrees C -- preserves cerebral energy metabolism, reduces cerebral tissue injury and improves neurological function. Randomized trials in full-term and near-full-term newborns suggest that treatment with mild hypothermia is safe and improves survival without disabilities up to 18 months of age. Although the optimal time of initiation, the depth and duration, and the method of cooling are uncertain, in the absence of specific treatments many clinicians will wish to consider treating asphyxiated infants with hypothermia. Guidance now needs to be provided to promote uniform practice, to avoid inappropriate treatment and to foster continuing collaboration in future studies of neuroprotection following asphyxia. If the promising results of the current trials are confirmed by the findings from other on-going studies, with longer follow-up, the impact of such a treatment on the babies, their families and health resources in the shorter and longer terms will be considerable.
Azzopardi
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Division of Clinical Sciences, Department of Medicine, Hammersmith Campus, Imperial College, DuCane Road, London, UK. d.azzopardi@imperial.ac.uk
Edwards
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AD
D000818:Animals; D001238:Asphyxia Neonatorum / Q000628:therapy*; D001831:Body Temperature; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D007231:Infant, Newborn; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome