Hypothermia therapy in neonatal hypoxic-ischemic encephalopathy: Current perspectives, combination therapy and future directions

Moaaz Abo Zeed ¹*, Maher Mohamad Najm ^2,3, Arwa Ajaj ⁴, Mohamad Ahmad Ajaj ⁵

Author Affiliation

¹Neonatal Intensive Care Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar 
^2,3 Pediatric Emergency Center, Hamad Medical Corporation, Doha, Qatar, 
⁴Sidra Medicine, Ar-Rayyan, Qatar
⁵Shmaisani Hospital, University of Jorden, Jordan

Abstract

Hypoxic-ischemic encephalopathy (HIE) in neonates, resulting from oxygen deprivation during birth, is a significant cause of death and long-term disabilities. Therapeutic hypothermia has emerged as a pivotal intervention for improving neurological outcomes in infants with HIE. This review aims to summarize current practices, outcomes, and challenges of hypothermia therapy in neonatal HIE, and adjuvant therapies, along with future directions in this evolving field. 

DOI: 10.18231/j.yjom.2024.019

Keywords: Therapeutic hypothermia, Hypoxic­ischemic encephalopathy, Cooling, Neonatal neuroprotection

Pages: 182-189

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Download: 45

DOI URL: https://doi.org/10.18231/j.yjom.2024.019

Publish Date: 15-12-2024

Full Text

Hypoxic-ischemic encephalopathy (HIE) is the suppression of brain activity with brain injury due to inadequate oxygen (hypoxia) or perfusion (ischemia) to the brain. HIE is a significant cause of neonatal mortality and morbidity worldwide. 10% to 60% of affected newborns die, and neurodevelopmental sequelae occur in at least 25% of survivors. 1,2 Adverse outcomes include developmental delay or intellectual impairment, cerebral palsy, epilepsy, sensorineural deafness, and blindness. The incidence of (HIE) is 1-2 per 1,000 live births in the Western world and is far more common in resource-limited countries, at 5– 40 in every 1,000 births. 3,4

The complicated pathophysiology of HIE consists of a primary (acute) phase, a secondary phase (latent), and a tertiary phase. It is further classified based on the severity into mild, moderate, or severe encephalopathy according to the degree of brain injury and neurological manifestations,

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