Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: short term results

Aytuğ Atıcı; Yalçın Çelik; Selvi Gülaşı; Ali Haydar Turhan; Çetin Okuyaz; Mehmet Ali Sungur

doi:10.5152/tpa.2015.2167

Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: short term results

Turk Pediatri Ars. 2015 Mar 1;50(1):27-36. doi: 10.5152/tpa.2015.2167. eCollection 2015 Mar.

Authors

Aytuğ Atıcı¹, Yalçın Çelik¹, Selvi Gülaşı¹, Ali Haydar Turhan¹, Çetin Okuyaz², Mehmet Ali Sungur³

Affiliations

¹ Department of Pediatrics, Division of Neanotology, Mersin University Faculty of Medicine, Mersin, Turkey.
² Department of Pediatrics, Division of Pediatric Neurology, Mersin University, Faculty of Medicine, Mersin, Turkey.
³ Department of Biostatistics and Medical Informatics, Mersin University Faculty of Medicine, Mersin, Turkey.

Abstract

Aim: In this study, it was aimed to investigate which method was superior by applying selective head cooling or whole body cooling therapy in newborns diagnosed with moderate or severe hypoxic ischemic encephalopathy.

Materials and method: Newborns above the 35th gestational age diagnosed with moderate or severe hypoxic ischemic encephalopathy were included in the study and selective head cooling or whole body cooling therapy was performed randomly. The newborns who were treated by both methods were compared in terms of adverse effects in the early stage and in terms of short-term results. Ethics committee approval was obtained for the study (06.01.2010/35).

Results: Fifty three babies diagnosed with hypoxic ischemic encephalopathy were studied. Selective head cooling was applied to 17 babies and whole body cooling was applied to 12 babies. There was no significant difference in terms of adverse effects related to cooling therapy between the two groups. When the short-term results were examined, it was found that the hospitalization time was 34 (7-65) days in the selective head cooling group and 18 (7-57) days in the whole body cooling group and there was no significant difference between the two groups (p=0.097). Four patients in the selective head cooling group and two patients in the whole body cooling group were discharged with tracheostomy because of the need for prolonged mechanical ventilation and there was no difference between the groups in terms of discharge with tracheostomy (p=0.528). Five patients in the selective head cooling group and three patients in the whole body cooling group were discharged with a gastrostomy tube because they could not be fed orally and there was no difference between the groups in terms of discharge with a gastrostomy tube (p=0.586). One patient who was applied selective head cooling and one patient who was applied whole body cooling died during hospitalization and there was no difference between the groups in terms of mortality (p=0.665).

Conclusions: There is no difference between the methods of selective head cooling and whole body cooling in terms of adverse effects and short-term results.

Keywords: Hypoxic ischemic encephalopathy; selective head cooling; whole body cooling.