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To cool or not to cool? Hypothermia treatment outside trial criteria

Topun Austin1, Shanthi Shanmugalingam, Paul Clarke

  • 1Neonatal Unit, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, UK. topun.austin@nhs.net

Archives of Disease in Childhood. Fetal and Neonatal Edition
|July 24, 2012
PubMed

Most infants undergoing therapeutic hypothermia for hypoxic-ischaemic encephalopathy fit the clinical criteria used in the main randomised controlled trials. Many infants who would not strictly have qualified for trial entry may nevertheless benefit from hypothermia. These may include infants presenting with postnatal collapse, infants with neonatal stroke and moderately preterm infants. Given the relative safety and potential lifelong benefits of hypothermia treatment, all patients who may benefit from cooling should receive it in a timely and consistent manner. This article reviews several clinical scenarios where cooling may be considered for neuroprotection and provides practical management guidance based on available evidence. The authors emphasise the importance of clear communication with parents and of maintaining national registers to record practices.

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