Induced hypothermia to treat neonatal hypoxic-ischemic encephalopathy. Review of literature with meta-analysis and development of national protocol.

Abstract

The efficacy of induced hypothermia to treat hypoxic-ischemic encephalopathy (HIE) in term infants has been evaluated in 6 multicenter randomized controlled trials. Meta-analysis of these trials shows that hypothermia in the first 6 hours after moderately severe HIE reduced the risk rate of death or neurological impairment at 18 months of age; risk ratio (RR): 0.81 (95% confidence interval [CI]: 0.71 to 0.93, p=0.002); risk difference -0.11 (95% CI: -0.18 to -0.04), with a number needed to treat of 9 (95% CI: 5-25). It also showed that treatment with hypothermia was associated with an increased rate of intact survival; RR: 1.53 (95% CI: 1.22-1.93, p<0.001); risk difference: 0.12 (95% CI: 0.06-0.18), with a number need to treat of 8 (95% CI: 5-17). We developed a national protocol using a simplified method of cooling. This protocol will hopefully lead to a widespread implementation of induced hypothermia in different settings within Saudi Arabia.

• Authors: Turki M Alkharfy
• Journal: Neurosciences (Riyadh, Saudi Arabia) (Neurosciences (Riyadh)) Vol. 18 Issue 1 Pg. 18-26 (Jan 2013) ISSN: 1319-6138 [Print] Saudi Arabia
• PMID: 23291793 (Publication Type: Journal Article, Meta-Analysis, Review)

Topics

• Animals
• Humans
• Hypothermia, Induced (methods, mortality, standards)
• Hypoxia-Ischemia, Brain (mortality, therapy)
• Infant
• Infant, Newborn
• Practice Guidelines as Topic
• Risk Factors
• Saudi Arabia (epidemiology)