Effect of therapeutic hypothermia on oxidative stress and outcome in term neonates with perinatal asphyxia: a randomized controlled trial.
OBJECTIVE
To evaluate in term babies with perinatal asphyxia, the effect of therapeutic hypothermia (TH) on oxidative stress and neurological outcome at discharge.


METHODS
Babies who satisfied inclusion criteria were randomized to TH, with cooling gel packs to a target temperature of 33-34°C for 72 h or normothermia. Blood sample was collected before and after TH for oxidative stress assessment: total antioxidant status (TAS) and malondialdehyde (MDA).


RESULTS
Of 116 babies randomized, there was no statistically significant difference in the baseline TAS and MDA. After 72 h of TH, TAS was significantly higher (p = <0.001) (761.69 ± 114.01 vs. 684.16 ± 88.86) and MDA was significantly lower (p = <0.001) in TH group (1.73 ± 0.66 vs. 5.2 ± 1.06). Risk of developing deficit was lower (p < 0.001) in TH group with relative risk of 0.49 and 95 % confidence interval: 0.29-0.68.


CONCLUSIONS
TH reduces oxidative stress and improves neurological outcome in perinatal asphyxia.


BACKGROUND
CTRI/2011/12/002196.
Department of Pediatrics Neonatology Division, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Puducherry 605 006, India.
Rojo
R
Joy
Femitha
F
Pournami
Adhisivam
A
Bethou
Vishnu B
VB
Bhat
Zachariah
Z
Bobby
D000328:Adult; D000975:Antioxidants / Q000032:analysis; D001238:Asphyxia Neonatorum / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D008315:Malondialdehyde; D018384:Oxidative Stress / Q000502:physiology*; D016037:Single-Blind Method; D016896:Treatment Outcome
D000975:Antioxidants; D008315:Malondialdehyde