What are the AHA and ILCOR guidelines for hypothermia therapy in 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

Predefined subgroup analysis in the CoolCap trial suggested that head cooling had no effect in infants with the most severe aEEG changes.

The findings were beneficial only in infants with less severe aEEG changes.

Hypothermia therapy has been recommended as the standard of care since 2010 by the AHA and ILCOR: "During the postresuscitation period in greater than or equal to 36-week gestation neonates with evolving moderate or severe encephalopathy, hypothermia should be offered in the context of clearly defined protocols similar to published trials.”

Hypothermia therapy should be conducted under strict protocols and reserved to regional referral centers offering comprehensive multidisciplinary care and planning to conduct long-term neurodevelopmental follow-up. Implementation requires thorough and ongoing education to avoid complications such as overcooling. [99] Ideally, all infants should be registered in national registry whenever possible.


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