Therapeutic hypothermia in asphyxiated newborns: selective head cooling vs. whole body cooling - comparison of short term outcomes

Ginekol Pol. 2019;90(7):403-410. doi: 10.5603/GP.2019.0069.

Abstract

Objectives: Therapeutic hypothermia TH became broadly used in the management of the asphyxiated newborns. Although two cooling methods are used, so far the superiority of none of them has been established. The purpose of the study is to compare two cooling methods: selective head cooling (SHC) and whole body cooling (WBC) MATERIAL AND METHODS: We conducted a prospective observational study in newborns with HIE. The patients received one of methods: SHC or WBC. The eligibility criteria were similar to previous studies. Stability of cardio-respiratory parameters and short term outcomes were analyzed.

Results: 78 neonates with hypoxic-ischemic encephalopathy due to perinatal asphyxia were involved in this study. The SHC group consisted of 51 newborns, the WBC group consisted of 27 patients. Both study groups had similar baseline characteristics and condition at birth. There were no significant differences in hospital course, neurological status and adverse effects associated with cooling procedure between groups. Analyzing the rate of thrombocytopenia and the number of transfusions of blood components no statistically significant differences were found between the groups.

Conclusions: Results of our study indicate that two compared methods of TH despite varied target core temperature ranges do not differ significantly according to clinical course and risk of adverse events. Further observations are conducted and we look forward to the results of the long neurodevelopmental care.

Trial registration: ClinicalTrials.gov NCT02499393.

Keywords: asphyxia; hypoxic–ischemic encephalopathy; newborn; selective head cooling; whole-body cooling.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / physiopathology
  • Asphyxia Neonatorum / therapy*
  • Blood Pressure / physiology
  • Body Temperature / physiology
  • Female
  • Head
  • Humans
  • Hypothermia, Induced / adverse effects
  • Hypothermia, Induced / methods*
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / physiopathology
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT02499393