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Therapeutic Hypothermia in Neonates

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Dr Muktanshu Patil    15 January 2018

  1. Therapeutic hypothermia (deliberate lowering of the body temperature) aims to cool the brain soon after birth and for several days afterwards to prevent brain damage. (Therapeutic hypothermia with intracorporeal temperature monitoring for hypoxic perinatal brain injury. Interventional Procedures Guidance; IPG347, 2010 May),
  2. The aim of intervention with hypothermia is to maintain a core temperature of 33.5°C for 72 hours, commencing as soon as possible after resuscitation.
  3. Current management of perinatal hypoxic-ischemic injury consists of maintaining physiological parameters within the normal range and treating seizures with anticonvulsants.
  4. The baby’s rectal and skin temperature is measured throughout.
  5. After cooling, the baby’s temperature is gradually returned to normal. The primary goal of rewarming is to slowly rewarm the baby over 6-12 hours.
  6. The management of cooled babies includes providing them with respiratory support; cardiovascular support and fl uid, electrolytes, and management of clotting abnormalities.
  7. There are no absolute contraindications to cooling infants who meet the criteria, except where there are other life-threatening congenital abnormalities present. Relative contraindications include >12 hours of age, with major congenital abnormalities, with severe coagulopathy, requiring inspired oxygen over 80%, ‘in extremis’ and not expected to survive.
  8. Cooling is concluded after 72 hours.

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