Determinants of outcome after head cooling for neonatal encephalopathy

S Wyatt, PD Gluckman, PY Liu, D Azzopardi, R Ballard, AD Edwards, DM Ferriero, RA Polin, CM Roberston, M Thoresen, A Whitelaw, AJ Gunn, Group the Coolcap Study

Research output: Contribution to journalArticle (Academic Journal)peer-review

303 Citations (Scopus)

Abstract

OBJECTIVE. The goal of this study was to evaluate the role of factors that may determine the efficacy of treatment with delayed head cooling and mild systemic hypothermia for neonatal encephalopathy. METHODS. A total of 218 term infants with moderate to severe neonatal encephalopathy plus abnormal amplitude-integrated electroencephalographic recordings, assigned randomly to head cooling for 72 hours, starting within 6 hours after birth (with the rectal temperature maintained at 34.5 ± 0.5°C), or conventional care, were studied. Death or severe disability at 18 months of age was assessed in a multicenter, randomized, controlled study (the CoolCap trial). RESULTS. Treatment, lower encephalopathy grade, lower birth weight, greater amplitude-integrated electroencephalographic amplitude, absence of seizures, and higher Apgar score, but not gender or gestational age, were associated significantly with better outcomes. In a multivariate analysis, each of the individually predictive factors except for Apgar score remained predictive. There was a significant interaction between treatment and birth weight, categorized as ≥25th or
Translated title of the contributionDeterminants of outcome after head cooling for neonatal encephalopathy
Original languageEnglish
Pages (from-to)912 - 921
Number of pages10
JournalPediatrics
Volume119 (5)
DOIs
Publication statusPublished - May 2007

Bibliographical note

Publisher: American Academy of Pediatrics

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