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Physiological responses to hypothermia.

Thomas Wood1, Marianne Thoresen2

  • 1Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

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Summary

Therapeutic hypothermia is crucial for neonatal hypoxic-ischaemic encephalopathy. This review details its effects on infant physiology, including respiratory, cardiovascular, and metabolic changes, and impacts on drug metabolism.

Keywords:
Blood gasCardiovascularHypothermiaHypoxia‒ischaemiaMetabolismNeonatalPharmacology

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Area of Science:

  • Neonatal physiology
  • Therapeutic hypothermia
  • Hypoxic-ischaemic encephalopathy

Background:

  • Therapeutic hypothermia is the sole recommended treatment for moderate to severe hypoxic-ischaemic encephalopathy in term neonates.
  • Existing data on hypothermia's physiological effects often derive from animal or adult studies, necessitating a neonatal-specific context.
  • Perinatal asphyxia induces significant physiological sequelae in neonates, influencing hypothermia's impact.

Purpose of the Study:

  • To review the multifaceted effects of therapeutic hypothermia on neonatal physiology.
  • To discuss potential complications and management considerations during therapeutic hypothermia.
  • To examine alterations in drug metabolism and dosing during neonatal therapeutic hypothermia.

Main Methods:

  • Literature review focusing on therapeutic hypothermia in neonates with hypoxic-ischaemic encephalopathy.
  • Analysis of physiological parameters including respiratory, cardiovascular, and metabolic functions.
  • Examination of drug pharmacokinetics, pharmacodynamics, and dosing adjustments.

Main Results:

  • Hypothermia significantly impacts neonatal respiratory, cardiovascular, and metabolic systems.
  • Potential pitfalls in blood-gas analysis and cardiovascular parameter management are identified.
  • Drug metabolism, pharmacokinetics, pharmacodynamics, and dosing require careful consideration during hypothermia.

Conclusions:

  • Therapeutic hypothermia requires careful monitoring of neonatal physiological parameters.
  • Understanding altered drug metabolism is critical for safe and effective neonatal intensive care during hypothermia.
  • Further research is needed to optimize therapeutic hypothermia protocols for neonates.