title: Induced hypothermia to treat neonatal hypoxic-ischemic encephalopathy. Review of literature with meta-analysis and development of national protocol.
abstract: The efficacy of induced hypothermia to treat hypoxic-ischemic encephalopathy (HIE) in term infants has been evaluated in 6 multicenter randomized controlled trials. Meta-analysis of these trials shows that hypothermia in the first 6 hours after moderately severe HIE reduced the risk rate of death or neurological impairment at 18 months of age; risk ratio (RR): 0.81 (95% confidence interval [CI]: 0.71 to 0.93, p=0.002); risk difference -0.11 (95% CI: -0.18 to -0.04), with a number needed to treat of 9 (95% CI: 5-25). It also showed that treatment with hypothermia was associated with an increased rate of intact survival; RR: 1.53 (95% CI: 1.22-1.93, p<0.001); risk difference: 0.12 (95% CI: 0.06-0.18), with a number need to treat of 8 (95% CI: 5-17). We developed a national protocol using a simplified method of cooling. This protocol will hopefully lead to a widespread implementation of induced hypothermia in different settings within Saudi Arabia.
authors.affiliation: Department of Pediatrics, King Khalid University Hospital, King Saud University, Kingdom of Saudi Arabia. tkharfi@ksu.edu.sa
authors.forename: Turki M
authors.initials: TM
authors.lastname: Alkharfy
mesh_terms: D000818:Animals; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods* / Q000401:mortality / Q000592:standards*; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality* / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology