When should hypothermia therapy be initiated for hypoxic-ischemic encephalopathy (HIE)?

Updated: Jul 18, 2018
  • Author: Santina A Zanelli, MD; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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Answer

Cooling must begin early, within 6 hours of injury. However, experimental evidence strongly suggest that the earlier the better.

Reports on the feasibility and safety of cooling on transport indicate that initiation of hypothermia therapy at referring centers is possible, provided that ongoing education is in place. [97] The ICE trial confirmed that a simplified method using widely available icepacks is an effective way to provide hypothermia therapy in referring centers while awaiting transfer to a tertiary neonatal intensive care unit (NICU). [88]

However, a favorable outcome may be possible if the cooling begins beyond 6 hours after injury. A current National Institute of Child Health and Human Development (NICHD) study is evaluating the efficacy of delayed hypothermia therapy for infants presenting at referral centers beyond 6 hours of life or with evolving encephalopathy.


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