The safety and practicality of selective head cooling in asphyxiated human newborn infants, a retrospective study

To evaluate the practicality and safety of selective head cooling in asphyxiated human newborn infants.

Retrospective chart analysis of asphyxiated neonates. SETTING, PATIENTS AND INTERVENTION: During a period of 13 months (1st June 1998 to 30 June 1999) fourteen newborns (10 mild and 4 moderate PHIE) were managed by selective head-cooling (mean GA 38.8 +/- 2.3) and 12 newborns (9 mild and 3 moderate PHIE) were managed conservatively without head cooling and served as controls (mean GA 39.1 +/- 1.6). Selective head cooling was accomplished by applying cool-packs to the parieto-temporal regions.

There were no significant differences in the perinatal characteristics of the two groups. The mean scalp temperature of 33.8 +/- 0.4 degrees C (28.7-36.5 degrees C) was lower than the mean body temperature of 35.8 +/- 0.2 degrees C (32.2-37.0 degrees C) in the study group during the cooling period, compared to a mean body temperature of 36.7 +/- 0.2 degrees C (36.1-37.3 degrees C) in the control group during the study period. There were no significant differences in the incidence of possible adverse effects between the two groups of infants. No infants developed cardiac arrhythmia, bradycardia, pulmonary edema or hemorrhage, metabolic acidosis, hypoglycemia, hypokalemia, NEC, systemic infection, thrombocytopenia, polycythemia, or cavernous sinus thrombosis during cooling.

Our data demonstrates that selective head cooling is practical and effective in keeping a gradient between the scalp and body temperature with no observed systemic side effects.