title: Whole body cooling in newborn infants with perinatal asphyxial encephalopathy in a low resource setting: a feasibility trial.
abstract: OBJECTIVE
  To determine the feasibility and safety of whole body cooling in newborn infants with perinatal asphyxial encephalopathy in a low resource setting.
  
  
  METHODS
  Feasibility trial.
  
  
  METHODS
  Tertiary care perinatal centre.
  
  
  METHODS
  Infants born at > 35 weeks gestation with perinatal asphyxia were included in the study.
  
  
  METHODS
  Infants were cooled to a rectal temperature of 33 ± 0.5°C for 72 hours using cloth-covered ice-gel packs. Vital parameters were monitored continuously.
  
  
  METHODS
  The primary outcome was the achievement of target temperature within 1 hour of initiation of treatment and maintaining the target temperature for 72 hours. Adverse events and possible complications of hypothermia were the secondary outcomes measured.
  
  
  RESULTS
  Twenty infants were included in the study. The mean time taken to achieve target rectal temperature was 52 ± 25 minutes. The mean rectal temperature during cooling was 32.9 ± 0.11ºC. The target temperature could be maintained for 72 hours without difficulty in all babies. Adverse events observed during cooling were thrombocytopenia (25%), sinus bradycardia (25%), deranged bleeding parameters (20%), aposteatonecrosis (15%), hyperglycemia (15%), hypoglycemia (10%), hypoxemia (5%), life-threatening coagulopathy (5%) and death (5%). Shivering was noted in many of the babies, especially in the initial phase of cooling.
  
  
  CONCLUSIONS
  Whole body cooling in term infants with perinatal asphyxia is achievable, safe and inexpensive in a low-resource setting.
authors.affiliation: Neonatology Unit, Christian Medical College Hospital, Vellore, India. niranjan@cmcvellore.ac.in
authors.forename: Niranjan
authors.initials: N
authors.lastname: Thomas
authors.forename: Koshy C
authors.initials: KC
authors.lastname: George
authors.forename: Santhanam
authors.initials: S
authors.lastname: Sridhar
authors.forename: Manish
authors.initials: M
authors.lastname: Kumar
authors.forename: Kurien Anil
authors.initials: KA
authors.lastname: Kuruvilla
authors.forename: Atanu Kumar
authors.initials: AK
authors.lastname: Jana
mesh_terms: D001238:Asphyxia Neonatorum / Q000628:therapy*; D001921:Brain / Q000502:physiology; D003906:Developing Countries; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000191:economics / Q000379:methods*; D002534:Hypoxia, Brain / Q000628:therapy*; D007194:India; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000191:economics / Q000379:methods*; D008297:Male