To determine the practicality and safety of head cooling with mild or minimal systemic hypothermia in term neonates with moderate to severe hypoxic-ischemic encephalopathy.
Study group infants >=37 weeks'gestation, who had an umbilical artery pH <=7.09 or Apgars<6 at 5 minutes, plus evidence of encephalopathy.
Infants with major congenital abnormalities were excluded.
Infants were randomized to either no cooling (controls ; rectal temperature=37.0 ± 0.2°C, n=10) or sequentially, either minimal systemic cooling (rectal temperature=36.3 ± 0.2°C, n=6) or mild systemic cooling (rectal temperature=35.7 ± 0.2°C, n=6).
Head cooling was accomplished by circulating water at 10°C through a coil of tubing wrapped around the head for up to 72 hours.
All infants were warmed by servo-controlled overhead heaters to maintain the allocated rectal temperature.
The rectal, fontanelle, and nasopharyngeal temperatures were continuously monitored.
From January 1996 to October 1997,22 term infants were randomized from 2 to 5 hours after birth.
All infants showed a metabolic acidosis at delivery, with similar umbilical artery pH in the control group (mean ± standard deviation, 6.79 ± 0.25), minimal cooling group (6.98 ± 0.21), and mild cooling group (6.93 ± 0.11), and depressed Apgar scores at 5 minutes in the control group (4.5 ± 2), minimal cooling group, (4.7 ± 2) and mild cooling group (6.0 ± 1). (...)
Mots-clés Pascal : Ischémie, Hypoxie, Nouveau né pathologie, Encéphalopathie, Soin intensif, Hypothermie, Encéphale, Prévention, Complication, Etude comparative, Appareil circulatoire pathologie, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie
Mots-clés Pascal anglais : Ischemia, Hypoxia, Newborn diseases, Encephalopathy, Intensive care, Hypothermia, Brain (vertebrata), Prevention, Complication, Comparative study, Cardiovascular disease, Nervous system diseases, Central nervous system disease, Cerebral disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0510636
Code Inist : 002B27B11. Création : 23/03/1999.