Blanket temperature during therapeutic hypothermia and outcomes in hypoxic ischemic encephalopathy

Objective Determine whether blanket temperatures during therapeutic hypothermia (TH) are associated with 18-22 month outcomes for infants with hypoxic ischemic encephalopathy (HIE). Study design Retrospective cohort study of 181 infants with HIE who received TH in two randomized trials within the Neonatal Research Network. We defined summative blanket temperature constructs and evaluated for association with a primary composite outcome of death or moderate/ severe disability at 18-22 months. Results Each 0.5 degrees C above 33.5 degrees C in the mean of the highest quartile blanket temperature was associated with a 52% increase in the adjusted odds of death/ disability (aOR 1.52, 95% CI 1.09-2.11). Having >8 consecutive blanket temperatures above 33.5 degrees C rendered an aOR of death/disability of 5.04 in the first 24 h (95% CI 1.54-16.6) and 6.92 in the first 48 h (95% CI 2.20-21.8) of TH. Conclusions Higher blanket temperature during TH may be an early, clinically useful biomarker of HIE outcome.

Automated summary

The study found that higher blanket temperatures during therapeutic hypothermia may be associated with increased risk of death or disability in infants with hypoxic ischemic encephalopathy (HIE) at 18-22 months. Particularly, having more than 8 consecutive blanket temperatures above 33.5 degrees Celsius in the first 24 hours is linked to a significantly higher risk.