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[Efficacy and securyty of therapeutic hypothermia for hypoxic ischemic encephalopathy: a meta-analysis]

A Rizzotti, José Bas, Eduardo Cuestas
Revista de la Facultad de Ciencias Médicas 2010, 67 (1): 15-23
21192128

BACKGROUND: Animal and human experimental models suggest that therapeutic hypothermia could reduce neurological disabilities in asphyxiated newborn without adverse events. The objective of this study was review the effectiveness and safety of hypothermia as treatment for hypoxic ischemic encephalophaty.

METHODS: MEDLINE, COCHRANE LIBRARY, Academic Google and LILACS databases were searched. Randomized controlled trials with main outcomes of death, neurodevelopmental disability and adverse events were eligible for inclusion in the meta-analysis.

RESULTS: Tree studies were included with 751 patients. Combined results of death reduction was not significant (RR 0.83 CI95% 0.67 to 1.04). Severe to moderate neurodevelopmental disability (RR 0.70 CI95% 0.55 to 0.89) and cerebral palsy (RR 0.66 CI95% 0.50 to 0.89) were reduced significantly in newborns receiving hypothermia compared with controls. Cardiac arrhythmias (RR 3.51 CI95% 1.29 to 9.54) and coagulation disorders (RR 1,23 CI95% 1.03 a 1.48) were more common adverse events with hypothermia.

CONCLUSIONS: Hypothermia is effective in reducing neurological disability and cerebral palsy. Cardiac arrhythmias and coagulation disorders were more common with hypothermia, however they were clinically benign.

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