[Induced hypothermia in infants born with hypoxic-ischaemic encephalopathy].

INTRODUCTION: Randomised studies have demonstrated the efficacy of hypothermia for the treatment of perinatal hypoxic-ischaemic encephalopathy (HIE) in term or late preterm infants. In August 2006, the Neonatology Department at Rigshospitalet, Copenhagen, introduced total body cooling for infants born at term with HIE.

MATERIAL AND METHODS: This retrospective study comprises data from medical records of newborn children born with HIE during a period of 32 months. Relevant data for cooling were recorded. Structured neurological examinations were carried out on survivors when they were ten and or 18 months old.

RESULTS: A total of 32 infants fulfilled the criteria for cooling, the incidence being 0.4/1000 births. Twenty infants were cooled for 72 hours. Eleven infants had cooling discontinued before 72 hours because of their grave prognosis. One infant had cooling discontinued because of pulmonary hypertension. Most infants were cooled before six hours of age (median four hours). The mortality rate was 41%. A total of 45% were cooled without being placed in a ventilator. The side effects were of no major concern. Eight children had a neurological follow-up. One child had developed cerebral palsy and two children suffered delayed development.

CONCLUSION: Total body cooling was carried out before six hours of age in the vast majority of infants born with HIE. Side effects were of less concern. Respiratory support with a ventilator could be avoided in 45% of the infants cooled for 72 hours. The mortality rate was 41%.