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Journal of Tropical Pediatrics Advance Access published online on September 30, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp089
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Evaluating a Simple Method of Neuroprotective Hypothermia for Newborn Infants

A.R. Horn, M.C. Harrison and L.L. Linley

Neonatal Medicine, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa

Correspondence: Alan Horn, Neonatal Medicine, H46 OMB, Groote Schuur Hospital, Observatory, 7925, Cape Town, South Africa. Tel.: +27-21-4046025; Fax: +27-21-447-1660; E-mail: <alan.horn{at}uct.ac.za>.


  Abstract

This study describes and evaluates a simple method of neuroprotective hypothermia for infants with hypoxic-ischaemic encephalopathy (HIE). Five term infants with HIE were cooled by applying soft, cold gel bags to the head. A radiant warmer, set to 34°C, servo-controlled the temperature measured at a probe between the infant’s back and the mattress. The infants’ heads were shielded from the warmer. After 72 h, the infants were re-warmed by 0.2°C per hour, by adjusting the radiant warmer. A rectal temperature of 34°C was attained in a median time of 45 min. Mean rectal temperatures during cooling were 33.9 ± 0.3°C. There was good correlation between insulated back temperatures and deep rectal temperatures (r = 0.76). There were no major or irreversible adverse events during cooling. This method of cooling achieved rectal temperatures within the target range of 33–34°C and re-warming was effective.

Key Words: newborn infant • therapeutic hypothermia • hypoxia-ischaemia • developing countries


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