Comparison of Two Low-cost Methods of Cooling Neonates with Hypoxic Ischemic Encephalopathy

Abstract

Both FGP and PCM are effective and safe, comparable with standard servo-controlled cooling equipment. PCM has the advantage of better maintenance of target temperature with less nursing input, when compared with FGP.

Hypothermic treatment for neonatal asphyxia in low‐resource settings using phase‐changing material—An easy to use and low‐cost method

“…In the study by Thomas et al, 22 different types of PCM blocks with different melting points (29°C and 21°C) were used for interventions similar to those of our study, but with PCM blocks added or removed to adjust temperatures. Many other ‘low‐tech’ cooling methods, such as ice or frozen gel packs, are also labour intensive, and may result in marked temperature fluctuations and shivering, with a potential loss of neuroprotective efficacy 23–25 …”

Therapeutic Hypothermia for Perinatal Asphyxia in Low-Resource Settings

“…The study sites chosen may have access to 3 Tesla MRI scanners and spectroscopy but that does not imply that their care for the study participants would match the standard of care and experience available in centers which are routinely cooling babies. Contrary to the results of a systematic review [5,6] and studies reported from various sites in India [7][8][9][10][11][12][13][14][15][16], higher mortality and morbidity in the HELIX trial need to be explored. In the HELIX trial, chronic hypoxic changes in MRI were recorded.…”

“…The authors have self-proclaimed that HELIX is the only phase III clinical trial in LMIC belittling all the research work done in LMIC including that in CMC, Vellore and Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry in this area [7][8][9][10][11][12][13][14][15][16]. It is mentioned in the review that between 2012 and 2020, six randomized controlled trials (RCTs) were reported from JIP-MER, Puducherry.…”

Hypoxic-ischaemic encephalopathy: Identifying newborns who will benefit from therapeutic hypothermia in developing countries

“…[32] A study comparing two commonly used low-cost methods of cooling, namely frozen gel packs and phase-changing material, showed that both methods are as effective as servo-controlled methods of TH with similar complication rates and short-term outcomes. [33] It has also been investigated whether a longer duration of cooling of 120 hours or deeper cooling to 32 º C or both will have further neuroprotective benefits above the current recommendations. However, both of these variations have significantly increased complications, and have not demonstrated any benefit to in-hospital survival.…”