Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: Short term results

Abstract

Aim: In this study, it was aimed to investigate which method was superior by applying selective head cooling or whole body cooling therapy in newborns diagnosed with moderate or severe hypoxic ischemic encephalopathy. Material and Methods: Newborns above the 35th gestational age diagnosed with moderate or severe hypoxic ischemic encephalopathy were included in the study and selective head cooling or whole body cooling therapy was performed randomly. The newborns who were treated by both methods were compared in terms of adverse effects in the early stage and in terms of short-term results. Ethics committee approval was obtained for the study (06.01.2010/35). Results: Fifty three babies diagnosed with hypoxic ischemic encephalopathy were studied. Selective head cooling was applied to 17 babies and whole body cooling was applied to 12 babies. There was no significant difference in terms of adverse effects related to cooling therapy between the two groups. When the short-term results were examined, it was found that the hospitalization time was 34 (7-65) days in the selective head cooling group and 18 (7-57) days in the whole body cooling group and there was no significant difference between the two groups (p=0.097). Four patients in the selective head cooling group and two patients in the whole body cooling group were discharged with tracheostomy because of the need for prolonged mechanical ventilation and there was no difference between the groups in terms of discharge with tracheostomy (p=0.528). Five patients in the selective head cooling group and three patients in the whole body cooling group were discharged with a gastrostomy tube because they could not be fed orally and there was no difference between the groups in terms of discharge with a gastrostomy tube (p=0.586). One patient who was applied selective head cooling and one patient who was applied whole body cooling died during hospitalization and there was no difference between the groups in terms of mortality (p=0.665). Conclusions: There is no difference between the methods of selective head cooling and whole body cooling in terms of adverse effects and short-term results. (Türk Ped Arş 2015; 50: 27-36)

Neuroprotection by Therapeutic Hypothermia

“…These two neuroprotections are similar, and whole-body cooling had a greater effect on the suppression of radical production than head cooling (Ikeda et al, 2012). A research study comparing selective head cooling therapy with whole body cooling therapy in newborns with hypoxic ischemic encephalopathy uncovered no difference between the two methods in terms of adverse effects and short-term results (Atici et al, 2015). Other research studies have also reached similar conclusion about hypoxic ischemic encephalopathy (Sarkar et al, 2009a,b; Celik et al, 2016).…”

Predictive factors of death in neonates with hypoxic-ischemic encephalopathy receiving selective head cooling

“…In the present study, there were significant correlations between the severity of HIE in neonates and the need for mechanical ventilation and 55% of newborns who underwent mechanical ventilation died. Atıcı et al [ 39 ] demonstrated 94% of HIE infants during the cooling process require mechanical ventilation and no differences were found between the 2 cooling methods. The involvement of other organs, including the lung, worsens the prognosis of neonatal HIE.…”

Therapeutic hypothermia in asphyxiated newborns: selective head cooling vs. whole body cooling — comparison of short term outcomes

“…The requirement for invasive mechanical ventilation, ability to perform extubation during the period of cooling and risk of PPHN were analyzed in two studies [25,27]. No differences were found between groups in regard to the need of mechanical ventilation during the cooling or ability to be extubated during the cooling.…”