Hypothermia of Some Benefit to Neonates With Encephalopathy
(HealthDay News) – For infants with neonatal hypoxic-ischemic encephalopathy, undergoing whole-body hypothermia results in lower mortality rates as well as a nonsignificant reduction in the combined end point of death or an IQ score of <70 at age 6–7 years, compared with usual care.
Seetha Shankaran, MD, from Wayne State University in Detroit, and colleagues reviewed long-term outcomes of a randomized trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy. Infants with moderate or severe encephalopathy were assigned to usual care (control group; 93 children) or whole-body cooling followed by slow rewarming (hypothermia group; 97 children). Cognitive, attention and executive, visuospatial, and neurologic function were evaluated, and physical and psychosocial health were assessed.
The researchers found that death or an IQ score <70 occurred in 47% of children in the hypothermia group and 62% of those in the control group (P=0.06); death occurred in 28 and 44%, respectively (P=0.04), and death or severe disability occurred in 41 and 60%, respectively (P=0.03). Moderate or severe disability occurred in 35% of 69 children in the hypothermia group and 38% of the 50 controls (P=0.87). Attention-executive dysfunction occurred in 4 and 13% of the hypothermia and usual-care groups (P=0.19), respectively, and visuospatial dysfunction occurred in 4 and 3%, respectively (P=0.8).
"In summary, whole-body hypothermia did not significantly reduce the rate of a composite end point of death or an IQ score <70 at 6–7 years of age," the authors write. "However, hypothermia resulted in lower death rates and did not increase rates of severe disability among survivors."
One author disclosed a financial relationship with MedImmune.