Hypothermia in neonatal hypoxic encephalopathy

Abstract

BACKGROUND: Hypoxic-ischemic encephalopathy is a major cause of acute neurological damage in the newborn. Hypothermia induced during the first hours of life of the newborn is an effective treatment to reduce mortality and major disability in children who survive after perinatal hypoxic-ischemic insult. OBJECTIVE: Describe the characteristics of patients with moderate to severe perinatal asphyxia with therapeutic hypothermia protocol; as well as evolution of psychomotor development and neurological sequelae. MATERIAL AND METHODS: Retrospective descriptive analysis of urgent hospitalizations of newborns who received therapy with active total body hypothermia. Clinical data, precise treatment, complementary tests, complications and neurological sequelae were collected. RESULTS: 51 cases were collected, of which 30 suffered from severe encephalopathy and 21 from moderate, according to the García Alix scale. Cranial MRI findings were consistent with mild (n = 9), moderate (n = 4), and severe (n = 19) hypoxic-ischemic encephalopathy. In 14 patients, no findings of hypoxic-ischemic encephalopathy were recorded. There were 16 deaths, 15 immediately after the adequacy of the therapeutic effort. At present, 15 patients with neurological sequelae remain in outpatient care; 8 were discharged because they were asymptomatic. 6 patients were lost to follow-up. CONCLUSIONS: Therapy with controlled hypothermia seems safe, demonstrating an improvement in the evolution of patients with moderate-severe hypoxic-ischemic encephalopathy.