Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Clinical Report
Santina Zanelli, Courtney J. Wusthoff, Ashley Lucke, David A. Kaufman, Eric Eichenwald, Namasivayam Ambalavanan, Charleta Guillory, M L Hudak, David A. Kaufman, Camilia Martin, Ashley Lucke, Margaret Parker, Arun Pramanik, Kelly Wade, Section on Neurology, Timothy Lotze, Capal JK, Marissa DiGiovine, Dalila Lewis, Renée A. Shellhaas, Courtney J. Wusthoff
Abstract
Therapeutic hypothermia to a temperature of 33.5 to 34.5 °C initiated within 6 hours of birth and continued for 72 hours reduces the risk of death or moderate-to-severe neurodevelopmental impairments in neonates with moderate-to-severe hypoxic-ischemic encephalopathy (HIE) born at ≥36 0/7 weeks of gestation. This specialized therapy requires neuromonitoring, neuroimaging, and plans for follow-up of neurodevelopmental outcomes. Any center or practitioner involved in newborn deliveries should have action plans for prompt recognition and initiation of therapeutic hypothermia or transfer of infants with possible HIE to a center providing therapeutic hypothermia. Because many neonates with HIE are born at places that do not provide therapeutic hypothermia, therapeutic hypothermia centers should work with their referring hospitals, birthing centers and practitioners to implement educational programs that focus on the identification, initial clinical management of affected neonates, and prompt transfer of neonates with moderate-to-severe HIE.