Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of brain injury in childhood. Infants with moderate encephalopathy have a 10 percent risk of death, and those who survive have a 30 percent risk of disabilities. Sixty percent of infants with severe encephalopathy die, and many, if not all, survivors are disabled. Whole-body hypothermia reduces the risk of death or disability in infants with moderate or severe hypoxic-ischemic encephalopathy.
Reductions in brain temperature by 2°C to 5°C provide neuroprotection in newborn and adult animal models of brain ischemia.Brain cooling has a favorable effect on multiple pathways contributing to brain injury, including excitatory amino acids, the cerebral energy state, cerebral blood flow and metabolism, nitric oxide production, and apoptosis. Brain cooling is effective in reducing the extent of brain injury even when it is initiated up to 5.5 hours after brain ischemia in near-term sheep fetuses.But, epidemiological data showed that, in non-developed countries and areas,Whole-body hypothermia is related to the increased mortality and brain injury. The cause is unclear.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
patients were allocated to modified Whole-Body Hypothermia with normal base excess and blood pressure
patients were allocated to standard Whole-Body Hypothermia
Children's Hospital of Chongqing Medical University
Chongqing, Chongqing Municipality, China
death
neonates are dead during hospital
Time frame: 30 days
brain injury
neonates are diagnosed with brain injury
Time frame: 30 days
the incidence of suspend of Whole-Body Hypothermia
Whole-Body Hypothermia is suspended
Time frame: within 3 days
the incidence of discharge according to the doctor's suggestion
neonates were discharged according to the doctor's suggestion
Time frame: 2-3 weeks
the incidence of intraventricular hemorrhage
intraventricular hemorrhage was diagnosed
Time frame: 2-3 week
the incidence of periventricular leukomalacia
Periventricular leukomalacia is diagnosed
Time frame: within 30 days
neurodevelopmental assessment
neurodevelopment is assessed using NBNA
Time frame: one month
neurodevelopmental assessment
neurodevelopment is assessed using Bayley scale
Time frame: 18-36 months
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