title: [Moderate cerebral hypothermia in hypoxic-ischaemic encephalopathy: Experience after one year].
abstract: BACKGROUND
  Moderate cerebral hypothermia has been shown to be an effective intervention in decreasing mortality and major disabilities in infants with moderate-severe hypoxic-ischaemic encephalopathy (HIE).
  
  
  OBJECTIVE
  To describe our experience within the first year of implementation, and to evaluate the feasibility and safety of this intervention.
  
  
  METHODS
  Retrospective study of 20 patients with moderate-severe HIE treated with whole body hypothermia in the Agrupación Sanitaria Hospital Sant Joan de Déu-Hospital Clínic, between January 2009 and June 2010.
  
  
  RESULTS
  During this period, 50 patients with perinatal HIE, 26 of them moderate- severe, were admitted to our units. Twenty patients received hypothermia (13 with severe and 7 with moderate HIE). All of them had at least one risk factor for perinatal hypoxia-ischaemia, and clinical signs of HIE. Fifteen had clinical and/or EEG seizures. Core temperature was maintained at 33.5 ± 0.5°C in 76.5% of determinations for infants cooled with a manual control device, and in 93.6% for those cooled with a servo-controlled device (P<.0001). Re-warming took a median time of 10.5 hours. No potentially severe complications related to hypothermia were observed. Seven patients (35%) died, all of them with severe HIE.
  
  
  CONCLUSIONS
  There were no difficulties in any of the steps of this intervention, and no potentially severe complications related to it were recorded. Both manual and servo-control methods are equally effective on maintaining the target temperature, although temperature shows less variability using the servo-controlled equipment.
authors.affiliation: Servicio de Neonatología, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Agrupació Sanitària Hospital Clínic-Hospital Sant Joan de Déu, Universitat de Barcelona, España. vtenorio@clinic.ub.es
authors.forename: V
authors.initials: V
authors.lastname: Tenorio
authors.forename: A
authors.initials: A
authors.lastname: Alarcón
authors.forename: A
authors.initials: A
authors.lastname: García-Alix
authors.forename: G
authors.initials: G
authors.lastname: Arca
authors.forename: M
authors.initials: M
authors.lastname: Camprubí
authors.forename: T
authors.initials: T
authors.lastname: Agut
authors.forename: J
authors.initials: J
authors.lastname: Figueras
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors