title: Minimal systemic hypothermia combined with selective head cooling evaluated in a pig model of hypoxia-ischemia.
abstract: BACKGROUND
  Selective head cooling (SHC) with moderate hypothermia (HT) and whole-body cooling are beneficial following perinatal asphyxia. SHC with systemic normothermia (NT) or minimal HT is under-investigated, could obviate systemic complications of moderate HT, and be applicable to preterm infants. We hypothesized that minimal systemic HT with SHC following hypoxia-ischemia (HI) would be neuroprotective compared with systemic NT.
  
  
  METHODS
  Newborn pigs underwent global HI causing permanent brain injury before being randomized to NT (rectal temperature (Trectal) 38.5 °C) or minimal HT (Trectal 37.0 °C) with SHC (cooling cap and body wrap) for 48 h followed by 24-h NT with 72-h survival.
  
  
  RESULTS
  SHC did not reduce global or regional neuropathology score when correcting for insult severity or compared with a NT group matched for HI severity but increased mortality by 26%. During 48 h, the SHC mean ± SD Trectal was 37.0 ± 0.2 °C, and Tdeep brain and Tsuperficial brain were 35.0 ± 1.1 °C and 31.5 ± 1.6 °C, respectively, with stable Tbrain achieved ≥ 3 h after starting cooling.
  
  
  CONCLUSIONS
  This is the first study in newborn pigs of minimal systemic HT with SHC for 48 h and a further 24 h of NT following HI. Mortality was increased in the cooled group with no neuroprotection in survivors.
authors: Neonatal Neuroscience, School of Clinical Sciences, University of Bristol, Bristol, Avon, UK.
authors: Nicholas
authors: N
authors: Hoque
authors: Neonatal Neuroscience, School of Clinical Sciences, University of Bristol, Bristol, Avon, UK.
authors: Xun
authors: X
authors: Liu
authors: Neonatal Neuroscience, School of Clinical Sciences, University of Bristol, Bristol, Avon, UK.
authors: Ela
authors: E
authors: Chakkarapani
authors: 1] Neonatal Neuroscience, School of Clinical Sciences, University of Bristol, Bristol, Avon, UK [2] Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
authors: Marianne
authors: M
authors: Thoresen
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001237:Asphyxia; D001238:Asphyxia Neonatorum / Q000473:pathology; D001831:Body Temperature; D004195:Disease Models, Animal; D005260:Female; D006257:Head / Q000473:pathology; D006624:Hippocampus / Q000378:metabolism; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000473:pathology*; D016014:Linear Models; D008297:Male; D018696:Neuroprotective Agents / Q000737:chemistry; D012640:Seizures / Q000503:physiopathology; D013552:Swine; D013997:Time Factors
chemical_list: D018696:Neuroprotective Agents