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Vol. 104, No. 3, 2013
Issue release date: September 2013
Section title: Original Paper
Neonatology 2013;104:228-233
(DOI:10.1159/000353948)

Time Is Brain: Starting Therapeutic Hypothermia within Three Hours after Birth Improves Motor Outcome in Asphyxiated Newborns

Thoresen M. · Tooley J. · Liu X. · Jary S. · Fleming P. · Luyt K. · Jain A. · Cairns P. · Harding D. · Sabir H.
aNeonatal Neuroscience, School of Clinical Sciences, University of Bristol, St. Michael's Hospital, Bristol, and bNeonatal Unit, University Hospitals Bristol, St. Michael's Hospital, Bristol, UK; cDepartment of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/4/2013 10:53:24 AM
Accepted: 6/18/2013
Published online: 9/12/2013

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

Objective: Therapeutic hypothermia (HT) is the standard treatment for newborns after perinatal asphyxia. Preclinical studies report that HT is more effective when started early. Methods: Eighty cooled newborns were analyzed and grouped according to when cooling was started after birth: early (≤180 min) or late (>181 min). For survivors we analyzed whether starting cooling early was associated with a better psychomotor or mental developmental index (PDI or MDI, Bayley Scales of Infant Development II) than late cooling. Results: Forty-three newborns started cooling early and 37 started late. There was no significant difference in the severity markers of perinatal asphyxia between the groups; however, nonsurvivors (n = 15) suffered more severe asphyxia and had significantly lower centiles for weight (BWC; p = 0.009). Of the 65 infants that survived, 35 were cooled early and 30 were cooled late. There was no difference in time to start cooling between those who survived and those who did not. For survivors, median PDI (IQR) was significantly higher when cooled early [90 (77-99)] compared to being cooled later [78 (70-90); p = 0.033]. There was no increase in cardiovascular adverse effects in those cooled early. There was no significant difference in MDI between early and late cooling [93 (77-103) vs. 89 (76-106), p = 0.594]. Conclusion: Starting cooling before 3 h of age in surviving asphyxiated newborns is safe and significantly improves motor outcome. Cooling should be initiated as soon as possible after birth in eligible infants.


  

Author Contacts

Marianne Thoresen, Professor of Neonatal Neuroscience
School of Clinical Sciences, University of Bristol
St. Michael's Hospital, Level D
Bristol BS2 8EG (UK)
E-Mail marianne.thoresen@bristol.ac.uk

  

Article Information

Received: April 4, 2013
Accepted after revision: June 18, 2013
Published online: September 12, 2013
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 3, Number of References : 25

  

Publication Details

Neonatology (Fetal and Neonatal Research)

Vol. 104, No. 3, Year 2013 (Cover Date: September 2013)

Journal Editor: Halliday H.L. (Belfast), Speer C.P. (Würzburg)
ISSN: 1661-7800 (Print), eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/4/2013 10:53:24 AM
Accepted: 6/18/2013
Published online: 9/12/2013

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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