Active cooling temperature required to achieve therapeutic hypothermia correlates with short-term outcome in neonatal hypoxic-ischemic encephalopathy.

This study demonstrates a correlation between servo-controlled mattress temperature during TH and short-term outcome. Neonates with an unfavorable outcome require less cooling to maintain a core temperature between 33-34 °C during TH compared to neonates with a favorable outcome. The degree of impaired temperature regulation was strongly associated with high MRI injury score and death. •Cooling device output temperature is a potential and easily obtainable early physiologic biomarker of outcome in infants with HIE undergoing TH. ABSTRACT: Neonatal hypoxic-ischemic encephalopathy (HIE) is a leading cause of death and disability in children. Therapeutic hypothermia (TH) at 33.5 °C for 72h is the only therapy to date shown to improve outcome in moderate to severe HIE; however, assessment of severity and prediction of outcome remains challenging. Infants with HIE display significant physiological perturbations, including spontaneous hypothermia. We hypothesized that neonates with more severe brain injury on magnet resonance imaging (MRI) would exhibit a greater degree of spontaneous hypothermia, and thus require less active cooling to attain TH. Twenty-eight neonates with moderate or severe HIE treated with TH were included in this study. MRI images obtained on day of life 4-7 were scored according to standardized injury criteria. Unfavorable outcome was defined as death or significant grey matter injury on MRI according to a previously validated scoring system. A s...
Source: The Journal of Physiology - Category: Physiology Authors: Tags: J Physiol Source Type: research