Journal
JORNAL DE PEDIATRIA
Volume 91, Issue -, Pages S78-S83Publisher
SOC BRASIL PEDIATRIA
DOI: 10.1016/j.jped.2015.07.004
Keywords
Hypothermia; Neonates; Perinatal asphyxia; Hypoxic-ischemic encephalopathy; Outcomes
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Objective: Therapeutic hypothermia reduces cerebral injury and improves the neurological outcome secondary to hypoxic ischemic encephalopathy in newborns. It has been indicated for asphyxiated full-term or near-term newborn infants with clinical signs of hypoxic-ischemic encephalopathy (HIE). Sources: A search was performed for articles on therapeutic hypothermia in newborns with perinatal asphyxia in PubMed; the authors chose those considered most significant. Summary of the findings: There are two therapeutic hypothermia methods: selective head cooling and total body cooling. The target body temperature is 34.5 degrees C for selective head cooling and 33.5 degrees C for total body cooling. Temperatures lower than 32 degrees C are less neuroprotective, and temperatures below 30 degrees C are very dangerous, with severe complications. Therapeutic hypothermia must start within the first 6 h after birth, as studies have shown that this represents the therapeutic window for the hypoxic-ischemic event. Therapy must be maintained for 72 h, with very strict control of the newborn's body temperature. It has been shown that therapeutic hypothermia is effective in reducing neurologic impairment, especially in full-term or near-term newborns with moderate hypoxic-ischemic encephalopathy. Conclusion: Therapeutic hypothermia is a neuroprotective technique indicated for newborn infants with perinatal asphyxia and hypoxic-ischemic encephalopathy. (C) 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
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