Related Experiment Video
Updated: Nov 9, 2025
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Body temperature, heart rate and long-term outcome of cooled infants: an observational study
Kennosuke Tsuda1,2, Jun Shibasaki3, Tetsuya Isayama4
1Department of Pediatrics, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan.
Insights
Therapeutic hypothermia is standard care for neonatal encephalopathy, but outcomes vary. This study found higher heart rates and higher body temperatures during cooling correlate with adverse outcomes in infants.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Critical Care Medicine
Background:
- Therapeutic hypothermia is a standard treatment for neonatal encephalopathy.
- Approximately 50% of infants do not respond favorably to this intervention.
- Emerging evidence suggests a link between temperature, heart rate, and outcomes in treated infants.
Purpose of the Study:
- To investigate the association between body temperature, heart rate, and adverse outcomes in newborn infants undergoing therapeutic hypothermia for neonatal encephalopathy.
- To identify physiological parameters that may predict treatment response and clinical outcomes.
Main Methods:
- Analysis of clinical data from 756 infants in the Baby Cooling Registry of Japan (2012-2016).
- Assessment of relationships between body temperature (admission and during cooling), heart rate (before and during cooling), and adverse outcomes (death or severe impairment at 18 months corrected age).
Main Results:
- Lower body temperature at admission was associated with adverse outcomes in univariate analysis but not in multivariate analysis.
- Higher body temperature during cooling and higher heart rate before and during cooling were significantly associated with adverse outcomes in both univariate and multivariate analyses.
- Severe hypoxia-ischemia may explain higher heart rates and lower admission temperatures.
Conclusions:
- Dual roles of body temperature in outcomes: lower admission temperature and higher cooling temperature are linked to adverse outcomes.
- Elevated heart rate before and during cooling is associated with adverse outcomes.
- Further research is needed to elucidate the mechanisms linking higher body temperature during cooling to adverse outcomes.
Background:
Therapeutic hypothermia is a standard of care for neonatal encephalopathy; however, approximately one in two newborn infants fails to respond to this treatment. Recent studies have suggested potential relationships between body temperature, heart rate and the outcome of cooled infants.
Methods:
The clinical data of 756 infants registered to the Baby Cooling Registry of Japan between January 2012 and December 2016 were analysed to assess the relationship between body temperature, heart rate and adverse outcomes (death or severe impairment at 18 months corrected age).
Results:
A lower body temperature at admission was associated with adverse outcomes in the univariate analysis (P < 0.001), the significance of which was lost when adjusted for the severity of encephalopathy and other covariates. A higher body temperature during cooling and higher heart rate before and during cooling were associated with adverse outcomes in both univariate (all P < 0.001) and multivariate (P = 0.012, P < 0.001 and P < 0.001, respectively) analyses.
Conclusions:
Severe hypoxia-ischaemia might be a common causative of faster heart rates before and during cooling and low body temperature before cooling, whereas causal relationships between slightly higher temperatures during cooling and adverse outcomes need to be elucidated in future studies.
Impact:
In a large cohort of encephalopathic newborn infants, dual roles of body temperature to the outcome were shown; adverse outcomes were associated with a lower body temperature at admission and higher body temperature during cooling. A higher heart rate before and during cooling were associated with adverse outcomes. Severe hypoxia-ischaemia might be a common causative of faster heart rates before and during cooling and low body temperature before cooling. The exact mechanism underlying the relationship between slightly higher body temperature during cooling and adverse outcomes remains unknown, which needs to be elucidated in future studies.
Related Concept Videos
01:14Temperature Measurement Sites
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...
01:29Decreased Body Temperature
01:19Assessing Body Temperature - Temporal Artery
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's...
01:27Assessing Body Temperature - Rectal
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
01:14Assessing Body Temperature - Oral
Step 1:
Start by practicing proper hand hygiene to prevent the spread of microorganisms.
Step 2:
Take the thermometer out of the charging unit, switch it on, and wait for the ready sign.
Step 3:
Gently slide the probe cover until a click is heard. This simple action prevents cross-contamination and ensures the correct placement of the probe cover.
Step 4:
Instruct the patient to open their mouth and place...
01:28Factors Affecting Body Temperature
Factors may include: