title: Heart Rate and Arterial Pressure Changes during Whole-Body Deep Hypothermia.
abstract: Whole-body deep hypothermia (DH) could be a new therapeutic strategy for asphyxiated newborn. This retrospective study describes how DH modified the heart rate and arterial blood pressure if compared to mild hypothermia (MH). Fourteen in DH and 17 in MH were cooled within the first six hours of life and for the following 72 hours. Hypothermia criteria were gestational age ≥36 weeks; birth weight ≥1800 g; clinical signs of moderate/severe hypoxic-ischemic encephalopathy. Rewarming was obtained in the following 6-12 hours (0.5°C/h) after cooling. Heart rates were the same between the two groups; there was statistically significant difference at the beginning of hypothermia and during rewarming. Three babies in the DH group and 2 in the MH group showed HR < 80 bpm and QTc > 520 ms. Infant submitted to deep hypothermia had not bradycardia or Qtc elongation before cooling and after rewarming. Blood pressure was significantly lower in DH compared to MH during the cooling, and peculiar was the hypotension during rewarming in DH group. Conclusion. The deeper hypothermia is a safe and feasible, only if it is performed by a well-trained team. DH should only be associated with a clinical trial and prospective randomized trials to validate its use.
authors.affiliation: NICU, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milan, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Cavallaro
authors.forename: Luca
authors.initials: L
authors.lastname: Filippi
authors.forename: Genny
authors.initials: G
authors.lastname: Raffaeli
authors.forename: Gloria
authors.initials: G
authors.lastname: Cristofori
authors.forename: Federico
authors.initials: F
authors.lastname: Schena
authors.forename: Elisa
authors.initials: E
authors.lastname: Agazzani
authors.forename: Ilaria
authors.initials: I
authors.lastname: Amodeo
authors.forename: Alice
authors.initials: A
authors.lastname: Griggio
authors.forename: Simona
authors.initials: S
authors.lastname: Boccacci
authors.forename: Patrizio
authors.initials: P
authors.lastname: Fiorini
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca