Risk Management: Cool Under Pressure: Neonatal Hypothermia
November 2011
Moderate to severe neonatal encephalopathy due to hypoxic-ischemic brain injury is an important cause of death and disability in near and full-term infants with an incidence of 1 - 6 per 1000 live births. In severe hypoxic-ischemic encephalopathy, the mortality rate is reportedly 25-50%.
Objectives:
The mechanism of damage in fetal/neonatal models of hypoxia-ischemia and how hypothermia therapy works, including the importance of timing of therapy initiation
A summary of prior published trial methods including the studies that utilized the cool cap and whole body hypothermia protocols and the more recent European and composite results.
Finally, we review the criteria for evaluation of moderate to severe neonatal encephalopathy, including the The American Academy of Pediatrics (AAP) and American College of Obstetrics and Gynecology (ACOG) published guidelines and what referral hospitals should know prior to referring and transporting infants for possible cooling therapy.
