Therapeutic hypothermia, the only evidence based treatment for infants born with neonatal encephalopathy (NE) at or after 36 weeks, is ineffective in reducing death or moderate/severe damage in infants born between 33 and 35 weeks, according to a new study.
The researchers examined the effectiveness of whole body therapeutic hypothermia in younger children, a routinely used treatment to reduce the body temperature of newborns and protect against the effects of mild or severe NE.
NE is a brain disorder that occurs at or just before birth and is often caused by a lack of oxygen to the brain. While there is evidence to support the use of therapeutic hypothermia in infants born at 36 weeks or later, many clinicians use it in infants born at 35 weeks or less.
168 newborns born between the ages of 33 and 36 were included in the study. week who had NO. Half of these newborns received therapeutic hypothermia, while the other half were kept at normal temperature for 72 hours. Study participants underwent brain MRI at 7 to 21 days and neuro-developmental testing with hearing and vision assessments at 18-22 months.
The researchers found a 77% increased chance of death compared to newborns in whom the researchers maintained a normal temperature. The researchers found no evidence that therapeutic hypothermia reduced the composite outcome of death or moderate/severe disability among study participants. Results were assessed at 18-22 months of age.
“Despite no evidence supporting its use in younger neonates, clinicians continue to use therapeutic hypothermia in neonates younger than 36 weeks,” said Roger G. Faix, M.D., professor of pediatrics/neonatology at the University of Utah and presenting author. “These study findings are clear: therapeutic hypothermia is ineffective in preterm infants.”
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