title: Therapeutic hypothermia for asphyxiated newborns: experience of an Israeli tertiary center.
abstract: BACKGROUND
  Major advances in the treatment of perinatal asphyxial-hypoxic ischemic encephalopathy (PA-HIE) followed the translation of hypothermia animal studies into successful randomized controlled clinical trials that substantially influenced the current standard of care.
  
  
  OBJECTIVE
  To present our preliminary experience with the first cases of clinical application of therapeutic hypothermia for PA-HIE in what we believe is the first report on nonexperimental hypothermia for PA-HIE from Israel.
  
  
  METHODS
  We reviewed the medical records, imaging scans, electroencephalograms and outcome data of the six identified asphyxiated newborns who were managed with hypothermia in our services in 2008-2009.
  
  
  RESULTS
  All asphyxiated newborns required resuscitation and were encephalopathic. Systemic hypothermia (33.5 degrees C) was begun at a median age of 4.2 hours of life (range 2.5-6 hours) and continued for 3 days. All six infants showed a significantly depressed amplitude integrated electroencephalography background, and five had electrographic seizures. One infant died (16%) after 3.5 days. Major complications included fat necrosis and hypercalcemia (n=1), pneumothorax (n=1), and meconium aspiration syndrome (n=2). None of the infants developed major bleeding. Neurodevelopmental followup of the five surviving infants at median age 7.2 months (4.1-18.5 months) revealed developmental delays (Battelle screening), with their motor scores ranging from -1 to +1 standard deviation (Bayley scale). None developed feeding problems, oculomotor abnormalities, spasticity or seizures.
  
  
  CONCLUSIONS
  Our preliminary experience with this novel modality in a large Tel Aviv neonatal service is consistent with the clinical findings of published trials.
authors: Child Neurology and Development Unit, Dana Children's Hospital, Israel.
authors: Yuval
authors: Y
authors: Landau
authors: Irit
authors: I
authors: Berger
authors: Ronela
authors: R
authors: Marom
authors: Dror
authors: D
authors: Mandel
authors: Liat
authors: L
authors: Ben Sira
authors: Aviva
authors: A
authors: Fattal-Valevski
authors: Tali
authors: T
authors: Peylan
authors: Loren
authors: L
authors: Levi
authors: Shaul
authors: S
authors: Dolberg
authors: Haim
authors: H
authors: Bassan
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D007557:Israel; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome