Therapeutic Hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy

Guido Wassink, Joanne O Davidson, Simerdeep K Dhillon, Kelly Zhou, Laura Bennet, Marianne Thoresen, Alistair J Gunn

Research output: Contribution to journalBook/Film/Article review (Academic Journal)peer-review

19 Citations (Scopus)
266 Downloads (Pure)

Abstract

Purpose of Review Therapeutic hypothermia reduces death or disability in term and near-term infants with moderate-severe
hypoxic-ischemic encephalopathy. Nevertheless, many infants still survive with disability, despite hypothermia, supporting
further research in to ways to further improve neurologic outcomes.
Recent Findings Recent clinical and experimental studies have refined our understanding of the key parameters for hypothermic
neuroprotection, including timing of initiation, depth, and duration of hypothermia, and subsequent rewarming rate. However,
important knowledge gaps remain. There is encouraging clinical evidence from a small phase II trial that combined treatment of
hypothermia with recombinant erythropoietin further reduces risk of disability but definitive studies are still needed.
Summary In conclusion, recent studies suggest that current protocols for therapeutic hypothermia are near-optimal, and that the
key to better neurodevelopmental outcomes is earlier diagnosis and initiation of hypothermia after birth. Further research is
essential to find and evaluate ways to further improve outcomes after hypoxic-ischemic encephalopathy, including add-on
therapies for therapeutic hypothermia and preventing pyrexia during labor and delivery.
Original languageEnglish
Article number2
Number of pages10
JournalCurrent Neurology and Neuroscience Reports
Volume19
Issue number1
Early online date14 Jan 2019
DOIs
Publication statusPublished - Jan 2019

Keywords

  • Neonatal encephalopathy
  • Therapeutic hypothermia
  • Neonatal neuroprotection
  • Fetal sheep
  • Erythropoietin
  • Neonatal examination

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