Neonatal encephalopathy: treatment with hypothermia

Abstract

In this article, the role of hypothermia and neuroprotection for neonatal encephalopathy will be discussed. The incidence of encephalopathy due to hypoxia ischemia as well as the pathophysiology will be presented. The diagnosis of encephalopathy in full-term neonates will be discussed. The current management of brain injury that occurs with hypoxia ischemia and the role of hypothermia in preventing brain injury in fetal and neonatal animal models will be reviewed. The current data from randomized control trials of hypothermia as neuroprotection for full-term infants will be presented along with the results of meta-analyses of these trials. Lastly, the status of ongoing neonatal hypothermia trials will be summarized.

Figures

FIG. 1.

Comparison of the percent of infants who died and survivors with a Mental Development Index (MDI, Bayley scores) of

FIG. 2.

Comparison of the percent of infants with disabling cerebral palsy (CP) and visual impairment (blindness) at 18–22 months in the CoolCap and Body Cooling trials. Disabling CP is based upon a Gross Motor Performance Score of 3–5 in the Body Cooling Trial and a classification of neuromotor disability in the CoolCap Trial. The number over each column represents the actual percent. Cont, control group; Cool, cooled group.