Neonatal Hypothermia

A Method to Provide Neuroprotection After Hypoxic Ischemic Encephalopathy

Katherine M. Newnam, MS, RN, CPNP, NNP-BC; Donna L. DeLoach, MS, RN, CPNP, NNP-BC

Disclosures

NAINR. 2011;11(3):113-124. 

In This Article

Incidence and Impact of HIE

Hypoxic ischemic encephalopathy or perinatal asphyxia affects one to three per 1000 live births in the United States.[2,6,7] Previous research has focused on the prevention of this type of birth injury as well as the development of treatment strategies, including hypothermia, in an effort to reduce mortality and morbidity.[8,9] Until the development and adaptation of these therapies, the care provided to these infants was primarily supportive with mortality rates ranging from 10% to 60% and of those who survived, morbidity rates approached 25%. It has been reported that 15% to 28% of the incidence of cerebral palsy among children are the result of perinatal asphyxia and HIE.[2,10] However, long-term outcomes are often difficult to predict. Infants who are minimally affected usually do not qualify for aggressive initial hypothermic treatment and, yet, may have residual deficits from the anoxic injury with later demonstration of both poor motor function and cognitive delays.

Infants identified as moderately affected often meet criteria for and receive hypothermia to provide neuroprotection. These infants showed the most significant improvement when compared with control groups in initial clinical trials as well as follow-up studies.[2] Severely affected infants who also meet criteria for hypothermia treatment showed slight improvement in mortality rates; however, most infants in the initial studies continue to have significant long-term consequences.[8,9]

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