Therapeutic Hypothermia in Perinatal Asphyxia
Keywords:
Therapeutic hypothermia, Asphyxia, perinatal asphyxia
Abstract
Therapeutic hypothermia for infants with perinatal asphyxia has been studied in several randomised controlled trials. There is convincing evidence that moderate therapeutic hypothermia (33-34°C for 72 h), when initiated within 6 h after birth among term & near-term infants (≥35 weeks) with moderate to severe HIE reduces the risk of death or major disability & increases the rate of disability-free survival at 6-7 years of age.
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References
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2. Snowden JM, Cheng YW, Kontgis CP, Caughey AB. The association between hospital obstetric volume and perinatal outcomes in California. Am J Obstet Gynecol. 2012 Dec;207(6):478.e1-7. doi: 10.1016/j.ajog.2012.09.029. Epub 2012 Oct 1.
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8. Shankaran SLA, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, Fanaroff AA, Poole WK, Wright LL, Higgins RD, Finer NN, Carlo WA, Duara S, Oh W, Cotten CM, Stevenson DK, Stoll BJ, Lemons JA, Guillet R, Jobe AH, National Institute of Child Health and Human Development Neonatal Research Network: Whole-body hypothermia for neonates with hypoxic ischemic encephalopathy. N Engl J Med. 2005 Oct 13;353(15):1574-84.
9. Eicher DJ, Wagner CL, Katikaneni LP, Hulsey TC, Bass WT, Kaufman DA, Horgan MJ, Languani S, Bhatia JJ, Givelichian LM, Sankaran K, Yager JY. Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr Neurol. 2005 Jan;32(1):11-7.
10. Azzopardi D, Strohm B, Edwards A, Dyet L, Halliday H, Juszczak E, Kapellou O, Levene M, Marlow N, Porter E, Thoresen M, Whitelaw A, Brocklehurst P, Group TS: Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med. 2009 Oct 1;361(14):1349-58. doi: 10.1056/NEJMoa0900854.
11. Shah PS. Hypothermia: a systematic review and meta-analysis of clinical trials. Semin Fetal Neonatal Med. 2010 Oct;15(5):238-46. doi: 10.1016/j.siny.2010.02.003. Epub 2010 Mar 7. [PubMed]
12. Edwards A, Brocklehurst P, Gunn A, Halliday H, Juszczak E, Levene M, Strohm B, Thoresen M, Whitelaw A, Azzopardi D: Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: Synthesis and meta-analysis of trial data. BMJ. 2010 Feb 9;340:c363. doi: 10.1136/bmj.c363.
13. Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013 Jan 31;1:CD003311. doi: 10.1002/14651858.CD003311.pub3.
14. Tagin MA, Woolcott CG, Vincer MJ, Whyte RK, Stinson DA. Hypothermia for neonatal hypoxic ischemic encephalopathy: an updated systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2012 Jun 1;166(6):558-66. doi: 10.1001/archpediatrics.2011.1772.
15. Shankaran S, Pappas A, McDonald SA, Vohr BR, Hintz SR, Yolton K, Gustafson KE, Leach TM, Green C, Bara R, Petrie Huitema CM, Ehrenkranz RA, Tyson JE,Das A, Hammond J, Peralta-Carcelen M, Evans PW, Heyne RJ, Wilson-Costello DE, Vaucher YE, Bauer CR, Dusick AM, Adams-Chapman I, Goldstein RF, Guillet R, Papile LA, Higgins RD; Eunice Kennedy Shriver NICHD Neonatal Research Network. Childhood outcomes after hypothermia for neonatal encephalopathy. N Engl J Med. 2012 May 31;366(22):2085-92. doi: 10.1056/NEJMoa1112066.
16. Gunn AJ, Gluckman PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study . Pediatrics. 1998 Oct;102(4 Pt 1):885-92. [PubMed]
17. Jacobs S, Stewart M, Inder T et al. ICE: the Australian cooling trial for hypoxic-ischemic encephalopathy-in hospital outcomes. Proceedings of the Hot Topics in Neonatology Conference. Washington DC, 2008.
18. Simbruner G, Mittal R, Rohlman F, Muche R. European nEURO.network trial. Proceedings of the Hot Topics in Neonatology Conference. Washington DC, Dec 7-9 2008.
19. Erecinska M, Thoresen M, Silver IA. Effects of hypothermia on energy metabolism in Mammalian central nervous system. J Cereb Blood Flow Metab. 2003 May;23(5):513-30. [PubMed]
20. Busto R, Globus MY, Dietrich WD, Martinez E, Valdés I, Ginsberg MD. Effect of mild hypothermia on ischemia-induced release of neurotransmitters and free fatty acids in rat brain. Stroke. 1989 Jul;20(7):904-10. [PubMed]
21. Thoresen M, Satas S, Puka-Sundvall M, Whitelaw A, Hallström A, Løberg EM, Ungerstedt U, Steen PA, Hagberg H. Post-hypoxic hypothermia reduces cerebrocortical release of NO and excitotoxins. Neuroreport. 1997 Oct 20;8(15):3359-62.
22. Nakashima K, Todd MM. Effects of hypothermia on the rate of excitatory amino acid release after ischemic depolarization. Stroke. 1996 May;27(5):913-8. [PubMed]
23. Globus MY, Alonso O, Dietrich WD, Busto R, Ginsberg MD. Glutamate release and free radical production following brain injury: effects of posttraumatic hypothermia. J Neurochem. 1995 Oct;65(4):1704-11. [PubMed]
24. Northington FJ, Graham EM, Martin LJ. Apoptosis in perinatal hypoxic-ischemic brain injury: how important is it and should it be inhibited? Brain Res Brain Res Rev. 2005 Dec 15;50(2):244-57. Epub 2005 Oct 10.
25. Ohmura A, Nakajima W, Ishida A, Yasuoka N, Kawamura M,Miura S, et al. Prolonged hypothermia protects neonatal ratbrain against hypoxic-ischemia by reducing both apoptosis and necrosis. Brain Dev. 2005;27:517---26.
26. Edwards AD, Yue X, Squier MV, Thoresen M, Cady EB, Penrice J, Cooper CE, Wyatt JS, Reynolds EO, Mehmet H. Specific inhibition of apoptosis after cerebral hypoxia-ischaemia by moderate post-insult hypothermia. Biochem Biophys Res Commun. 1995 Dec 26;217(3):1193-9.
27. Xu L, Yenari MA, Steinberg GK, Giffard RG. Mild hypothermia reduces apoptosis of mouse neurons in vitro early in the cascade. J Cereb Blood Flow Metab. 2002 Jan;22(1):21-8.
28. Zhang, Z; Sobel, RA; Cheng, D; Steinberg, GK; Yenari, MA. (2001). "Mild hypothermia increases Bcl-2 protein expression following global cerebral ischemia. Brain Res Mol Brain Res. 2001 Nov 1;95(1-2):75-85. doi:10.1016/S0169-328X(01)00247-9.
29. Cornette L. Therapeutic hypothermia in neonatal asphyxia. Facts Views Vis Obgyn. 2012;4(2):133-9. [PubMed]
30. Wassink G, Gunn ER1, Drury PP, Bennet L, Gunn AJ. The mechanisms and treatment of asphyxial encephalopathy. Front Neurosci. 2014 Feb 27;8:40. doi: 10.3389/fnins.2014.00040. eCollection 2014. [PubMed]
31. Gunn AJ, Gunn TR, Gunning MI, Williams CE, Gluckman PD. Neuroprotection with prolonged head cooling started before postischemic seizures in fetal sheep. Pediatrics. 1998 Nov;102(5):1098-106.
32. Silveira RC, Procianoy RS. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J Pediatr (Rio J). 2015 Nov-Dec;91(6 Suppl 1):S78-83. doi: 10.1016/j.jped.2015.07.004. Epub 2015 Sep 4. [PubMed]
33. Laptook AR, Shalak L, Corbett RJ. Differences in brain temperature and cerebral blood flow during selective head versus whole-body cooling. Pediatrics. 2001 Nov;108(5):1103-10. [PubMed]
34. Simbruner G, Haberl C, Harrison V, Linley L, Willeitner AE. Induced brain hypothermia in asphyxiated human newborn infants: a retrospective chart analysis of physiological and adverse effects. Intensive Care Med. 1999 Oct;25(10):1111-7.
35. Azzopardi D, Robertson NJ, Cowan FM, Rutherford MA, Rampling M, Edwards AD. Pilot study of treatment with whole body hypothermia for neonatal encephalopathy. Pediatrics. 2000 Oct;106(4):684-94.
36. Thoresen M, Whitelaw A. Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants with hypoxic-ischemic encephalopathy. Pediatrics. 2000 Jul;106(1 Pt 1):92-9. [PubMed]
37. Battin MR, Dezoete JA, Gunn TR, Gluckman PD, Gunn AJ. Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatalasphyxia. Pediatrics. 2001 Mar;107(3):480-4. [PubMed]
38. Shankaran S, Laptook A, Wright LL, Ehrenkranz RA, Donovan EF, Fanaroff AA, Stark AR, Tyson JE, Poole K, Carlo WA, Lemons JA, Oh W, Stoll BJ, Papile LA,Bauer CR, Stevenson DK, Korones SB, McDonald S. Whole-body hypothermia for neonatal encephalopathy: animal observations as a basis for a randomized,controlled pilot study in term infants. Pediatrics. 2002 Aug;110(2 Pt 1):377-85.
39. Fugelseth D, Satas S, Steen PA, Thoresen M. Cardiac output, pulmonary artery pressure, and patent ductusarteriosus during therapeutic cooling after global hypoxia-ischaemia. Arch Dis Child Fetal Neonatal Ed. 2003 May; 88(3): F223–F228. doi: 10.1136/fn.88.3.F223.
40. Zhou WH, Shao XM, Zhang XD, Chen C, Huang GY. [Effects of hypothermia on cardiac function in neonates with asphyxia]. Zhonghua Er Ke Za Zhi. 2003 Jun;41(6):460-2.
41. Biggar WD, Barker C, Bohn D, Kent G. Partial recovery of neutrophil functions during prolonged hypothermia in pigs. J Appl Physiol (1985). 1986 Apr;60(4):1186-9.
42. Thoresen M. Supportive care during neuroprotective hypothermia in the term newborn: adverse effects and their prevention. Clin Perinatol. 2008 Dec;35(4):749-63, vii. doi: 10.1016/j.clp.2008.07.018.
2. Snowden JM, Cheng YW, Kontgis CP, Caughey AB. The association between hospital obstetric volume and perinatal outcomes in California. Am J Obstet Gynecol. 2012 Dec;207(6):478.e1-7. doi: 10.1016/j.ajog.2012.09.029. Epub 2012 Oct 1.
3. Vannucci RC. Current and potentially new management strategies for perinatal hypoxic-ischemic encephalopathy. Pediatrics. 1990 Jun;85(6):961-8. [PubMed]
4. Robertson CM, Perlman M. Follow-up of the term infant after hypoxic-ischemic encephalopathy. Paediatr Child Health. 2006 May;11(5):278-82. [PubMed]
5. Lawn JE, Kinney M, Lee AC, Chopra M, Donnay F, Paul VK, Bhutta ZA, Bateman M, Darmstadt GL. Reducing intrapartum-related deaths and disability: can the health system deliver? Int J Gynaecol Obstet. 2009 Oct;107 Suppl 1:S123-40, S140-2. doi: 10.1016/j.ijgo.2009.07.021.
6. Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet. 2005 Mar 5-11;365(9462):891-900. [PubMed]
7. Gluckman PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM, Polin RA, Robertson CM, Thoresen M, Whitelaw A, Gunn AJ. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet. 2005 Feb 19-25;365(9460):663-70.
8. Shankaran SLA, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, Fanaroff AA, Poole WK, Wright LL, Higgins RD, Finer NN, Carlo WA, Duara S, Oh W, Cotten CM, Stevenson DK, Stoll BJ, Lemons JA, Guillet R, Jobe AH, National Institute of Child Health and Human Development Neonatal Research Network: Whole-body hypothermia for neonates with hypoxic ischemic encephalopathy. N Engl J Med. 2005 Oct 13;353(15):1574-84.
9. Eicher DJ, Wagner CL, Katikaneni LP, Hulsey TC, Bass WT, Kaufman DA, Horgan MJ, Languani S, Bhatia JJ, Givelichian LM, Sankaran K, Yager JY. Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr Neurol. 2005 Jan;32(1):11-7.
10. Azzopardi D, Strohm B, Edwards A, Dyet L, Halliday H, Juszczak E, Kapellou O, Levene M, Marlow N, Porter E, Thoresen M, Whitelaw A, Brocklehurst P, Group TS: Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med. 2009 Oct 1;361(14):1349-58. doi: 10.1056/NEJMoa0900854.
11. Shah PS. Hypothermia: a systematic review and meta-analysis of clinical trials. Semin Fetal Neonatal Med. 2010 Oct;15(5):238-46. doi: 10.1016/j.siny.2010.02.003. Epub 2010 Mar 7. [PubMed]
12. Edwards A, Brocklehurst P, Gunn A, Halliday H, Juszczak E, Levene M, Strohm B, Thoresen M, Whitelaw A, Azzopardi D: Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: Synthesis and meta-analysis of trial data. BMJ. 2010 Feb 9;340:c363. doi: 10.1136/bmj.c363.
13. Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013 Jan 31;1:CD003311. doi: 10.1002/14651858.CD003311.pub3.
14. Tagin MA, Woolcott CG, Vincer MJ, Whyte RK, Stinson DA. Hypothermia for neonatal hypoxic ischemic encephalopathy: an updated systematic review and meta-analysis. Arch Pediatr Adolesc Med. 2012 Jun 1;166(6):558-66. doi: 10.1001/archpediatrics.2011.1772.
15. Shankaran S, Pappas A, McDonald SA, Vohr BR, Hintz SR, Yolton K, Gustafson KE, Leach TM, Green C, Bara R, Petrie Huitema CM, Ehrenkranz RA, Tyson JE,Das A, Hammond J, Peralta-Carcelen M, Evans PW, Heyne RJ, Wilson-Costello DE, Vaucher YE, Bauer CR, Dusick AM, Adams-Chapman I, Goldstein RF, Guillet R, Papile LA, Higgins RD; Eunice Kennedy Shriver NICHD Neonatal Research Network. Childhood outcomes after hypothermia for neonatal encephalopathy. N Engl J Med. 2012 May 31;366(22):2085-92. doi: 10.1056/NEJMoa1112066.
16. Gunn AJ, Gluckman PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study . Pediatrics. 1998 Oct;102(4 Pt 1):885-92. [PubMed]
17. Jacobs S, Stewart M, Inder T et al. ICE: the Australian cooling trial for hypoxic-ischemic encephalopathy-in hospital outcomes. Proceedings of the Hot Topics in Neonatology Conference. Washington DC, 2008.
18. Simbruner G, Mittal R, Rohlman F, Muche R. European nEURO.network trial. Proceedings of the Hot Topics in Neonatology Conference. Washington DC, Dec 7-9 2008.
19. Erecinska M, Thoresen M, Silver IA. Effects of hypothermia on energy metabolism in Mammalian central nervous system. J Cereb Blood Flow Metab. 2003 May;23(5):513-30. [PubMed]
20. Busto R, Globus MY, Dietrich WD, Martinez E, Valdés I, Ginsberg MD. Effect of mild hypothermia on ischemia-induced release of neurotransmitters and free fatty acids in rat brain. Stroke. 1989 Jul;20(7):904-10. [PubMed]
21. Thoresen M, Satas S, Puka-Sundvall M, Whitelaw A, Hallström A, Løberg EM, Ungerstedt U, Steen PA, Hagberg H. Post-hypoxic hypothermia reduces cerebrocortical release of NO and excitotoxins. Neuroreport. 1997 Oct 20;8(15):3359-62.
22. Nakashima K, Todd MM. Effects of hypothermia on the rate of excitatory amino acid release after ischemic depolarization. Stroke. 1996 May;27(5):913-8. [PubMed]
23. Globus MY, Alonso O, Dietrich WD, Busto R, Ginsberg MD. Glutamate release and free radical production following brain injury: effects of posttraumatic hypothermia. J Neurochem. 1995 Oct;65(4):1704-11. [PubMed]
24. Northington FJ, Graham EM, Martin LJ. Apoptosis in perinatal hypoxic-ischemic brain injury: how important is it and should it be inhibited? Brain Res Brain Res Rev. 2005 Dec 15;50(2):244-57. Epub 2005 Oct 10.
25. Ohmura A, Nakajima W, Ishida A, Yasuoka N, Kawamura M,Miura S, et al. Prolonged hypothermia protects neonatal ratbrain against hypoxic-ischemia by reducing both apoptosis and necrosis. Brain Dev. 2005;27:517---26.
26. Edwards AD, Yue X, Squier MV, Thoresen M, Cady EB, Penrice J, Cooper CE, Wyatt JS, Reynolds EO, Mehmet H. Specific inhibition of apoptosis after cerebral hypoxia-ischaemia by moderate post-insult hypothermia. Biochem Biophys Res Commun. 1995 Dec 26;217(3):1193-9.
27. Xu L, Yenari MA, Steinberg GK, Giffard RG. Mild hypothermia reduces apoptosis of mouse neurons in vitro early in the cascade. J Cereb Blood Flow Metab. 2002 Jan;22(1):21-8.
28. Zhang, Z; Sobel, RA; Cheng, D; Steinberg, GK; Yenari, MA. (2001). "Mild hypothermia increases Bcl-2 protein expression following global cerebral ischemia. Brain Res Mol Brain Res. 2001 Nov 1;95(1-2):75-85. doi:10.1016/S0169-328X(01)00247-9.
29. Cornette L. Therapeutic hypothermia in neonatal asphyxia. Facts Views Vis Obgyn. 2012;4(2):133-9. [PubMed]
30. Wassink G, Gunn ER1, Drury PP, Bennet L, Gunn AJ. The mechanisms and treatment of asphyxial encephalopathy. Front Neurosci. 2014 Feb 27;8:40. doi: 10.3389/fnins.2014.00040. eCollection 2014. [PubMed]
31. Gunn AJ, Gunn TR, Gunning MI, Williams CE, Gluckman PD. Neuroprotection with prolonged head cooling started before postischemic seizures in fetal sheep. Pediatrics. 1998 Nov;102(5):1098-106.
32. Silveira RC, Procianoy RS. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J Pediatr (Rio J). 2015 Nov-Dec;91(6 Suppl 1):S78-83. doi: 10.1016/j.jped.2015.07.004. Epub 2015 Sep 4. [PubMed]
33. Laptook AR, Shalak L, Corbett RJ. Differences in brain temperature and cerebral blood flow during selective head versus whole-body cooling. Pediatrics. 2001 Nov;108(5):1103-10. [PubMed]
34. Simbruner G, Haberl C, Harrison V, Linley L, Willeitner AE. Induced brain hypothermia in asphyxiated human newborn infants: a retrospective chart analysis of physiological and adverse effects. Intensive Care Med. 1999 Oct;25(10):1111-7.
35. Azzopardi D, Robertson NJ, Cowan FM, Rutherford MA, Rampling M, Edwards AD. Pilot study of treatment with whole body hypothermia for neonatal encephalopathy. Pediatrics. 2000 Oct;106(4):684-94.
36. Thoresen M, Whitelaw A. Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants with hypoxic-ischemic encephalopathy. Pediatrics. 2000 Jul;106(1 Pt 1):92-9. [PubMed]
37. Battin MR, Dezoete JA, Gunn TR, Gluckman PD, Gunn AJ. Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatalasphyxia. Pediatrics. 2001 Mar;107(3):480-4. [PubMed]
38. Shankaran S, Laptook A, Wright LL, Ehrenkranz RA, Donovan EF, Fanaroff AA, Stark AR, Tyson JE, Poole K, Carlo WA, Lemons JA, Oh W, Stoll BJ, Papile LA,Bauer CR, Stevenson DK, Korones SB, McDonald S. Whole-body hypothermia for neonatal encephalopathy: animal observations as a basis for a randomized,controlled pilot study in term infants. Pediatrics. 2002 Aug;110(2 Pt 1):377-85.
39. Fugelseth D, Satas S, Steen PA, Thoresen M. Cardiac output, pulmonary artery pressure, and patent ductusarteriosus during therapeutic cooling after global hypoxia-ischaemia. Arch Dis Child Fetal Neonatal Ed. 2003 May; 88(3): F223–F228. doi: 10.1136/fn.88.3.F223.
40. Zhou WH, Shao XM, Zhang XD, Chen C, Huang GY. [Effects of hypothermia on cardiac function in neonates with asphyxia]. Zhonghua Er Ke Za Zhi. 2003 Jun;41(6):460-2.
41. Biggar WD, Barker C, Bohn D, Kent G. Partial recovery of neutrophil functions during prolonged hypothermia in pigs. J Appl Physiol (1985). 1986 Apr;60(4):1186-9.
42. Thoresen M. Supportive care during neuroprotective hypothermia in the term newborn: adverse effects and their prevention. Clin Perinatol. 2008 Dec;35(4):749-63, vii. doi: 10.1016/j.clp.2008.07.018.
CITATION
DOI: 10.17511/ijpr.2016.i02.10
Published: 2016-02-29
How to Cite
Dr. Rabindran, & Dr D Sharad Gedam. (2016). Therapeutic Hypothermia in Perinatal Asphyxia. Pediatric Review: International Journal of Pediatric Research, 3(2), 124-129. https://doi.org/10.17511/ijpr.2016.i02.10
Section
Review Article
Copyright (c) 2016 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
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