Can we further optimize therapeutic hypothermia for hypoxic-ischemic encephalopathy?
Anthony Davies
Guido Wassink
Laura Bennet
Alistair J. Gunn
Joanne O. Davidson
摘要：Perinatal hypoxic-ischemic encephalopathy is a leading cause of neonatal death and disability. Thera-peutic hypothermia significantly reduces death and major disability associated with hypoxic-ischemic encephalopathy; however, many infants still experience lifelong disabilities to movement, sensation and cognition. Clinical guidelines, based on strong clinical and preclinical evidence, recommend therapeu-tic hypothermia should be started within 6 hours of birth and continued for a period of 72 hours, with a target brain temperature of 33.5 ± 0.5°C for infants with moderate to severe hypoxic-ischemic encepha-lopathy. The clinical guidelines also recommend that infants be rewarmed at a rate of 0.5°C per hour, but this is not based on strong evidence. There are no randomized controlled trials investigating the optimal rate of rewarming after therapeutic hypothermia for infants with hypoxic-ischemic encephalopathy. Pre-clinical studies of rewarming are conflicting and results were confounded by treatment with sub-optimal durations of hypothermia. In this review, we evaluate the evidence for the optimal start time, duration and depth of hypothermia, and whether the rate of rewarming after treatment affects brain injury and neuro-logical outcomes.
机标关键词：
资助基金：The work was supported by The Health Research Council of New Zealand(grant 16/003. 17/601)the Marsden Fund (grant No. 17-UOA232)JOD holds a Sir Charles Hercus Fellowship from the Health Research Council of New Zealand (grant No. 16/003)Financial support(grant 16/003. 17/601)the Marsden Fund (grant No. 17-UOA232)JOD holds a Sir Charles Hercus Fel-lowship from the Health Research Council of New Zealand(grant 16/003)
论文发表日期：2019-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：6( 1678-1683 )
英文信息