Therapeutic Hypothermia Changes the Prognostic Value of Clinical Evaluation of Neonatal Encephalopathy

AJ Gunn, JS Wyatt, A Whitelaw, J Barks, D Azzopardi, R Ballard, AD Edwards, DM Ferriero, PD Gluckman, RA Polin, CM Robertson, M Thoresen, Group CoolCap Study

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

119 Citations (Scopus)

Abstract

Objective To evaluate whether therapeutic hypothermia alters the prognostic value of clinical grading of neonatal encephalopathy. Study design This study was a secondary analysis of a multicenter study of 234 term infants with neonatal encephalopathy randomized to head cooling for 72 hours starting within 6 hours of birth, with rectal temperature maintained at 34.5[degree sign]C +/- 0.5[degree sign]C, followed by re-warming for 4 hours, or standard care at 37.0[degree sign]C +/- 0.5[degree sign]C. Severity of encephalopathy was measured pre-randomization and on day 4, after re-warming, in 177 infants; 31 infants died before day 4, and data were missing for 10 infants. The primary outcome was death or severe disability at 18 months of age. Results Milder pre-randomization encephalopathy, greater improvement in encephalopathy from randomization to day 4, and cooling were associated with favorable outcome in multivariate binary logistic regression. Hypothermia did not affect severity of encephalopathy at day 4, however, in infants with moderate encephalopathy at day 4, those treated with hypothermia had a significantly higher rate of favorable outcome (31/45 infants, 69%, P = .006) compared with standard care (12/33, 36%). Conclusion Infants with moderate encephalopathy on day 4 may have a more favorable prognosis after hypothermia treatment than expected after standard care.
Translated title of the contributionTherapeutic Hypothermia Changes the Prognostic Value of Clinical Evaluation of Neonatal Encephalopathy
Original languageEnglish
Pages (from-to)55 - 58
Number of pages4
JournalJournal of Pediatrics
Volume152 (1)
DOIs
Publication statusPublished - Jan 2007

Bibliographical note

Publisher: Mosby

Fingerprint

Dive into the research topics of 'Therapeutic Hypothermia Changes the Prognostic Value of Clinical Evaluation of Neonatal Encephalopathy'. Together they form a unique fingerprint.

Cite this