Hypothermia: a systematic review and meta-analysis of clinical trials.
Hypothermia is a potential neuroprotective intervention to treat neonatal post-asphyxial (hypoxic-ischemic) encephalopathy (HIE). In this meta-analysis of 13 clinical trials published to date, therapeutic hypothermia was associated with a highly reproducible reduction in the risk of the combined outcome of mortality or moderate-to-severe neurodevelopmental disability in childhood. This improvement was internally consistent, as shown by significant reductions in the individual risk for death, moderate-to-severe neurodevelopmental disability, severe cerebral palsy, cognitive delay, and psychomotor delay. Patients in the hypothermia group had higher incidences of arrhythmia and thrombocytopenia; however, these were not clinically important. This analysis supports the use of hypothermia in reducing the risk of the mortality or moderate-to-severe neurodevelopmental disability in infants with moderate HIE.
Shah
Prakesh S
PS
Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada. pshah@mtsinai.on.ca
D001238:Asphyxia Neonatorum / Q000150:complications*; D003422:Critical Care / Q000379:methods*; D002658:Developmental Disabilities / Q000517:prevention & control*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D049590:Postpartum Period; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012720:Severity of Illness Index