In neonates with hypoxic ischemic encephalopathy, is therapeutic hypothermia outside of current criteria safe? A literature review

Abstract

Introduction: Hypoxic Ischemic Encephalopathy (HIE) can lead to catastrophic consequences. Published trials mean that Therapeutic Hypothermia has revolutionised available treatment but infants often must meet strict criteria. Objectives: To review relevant research that explores using Therapeutic Hypothermia in infants with HIE, who are usually excluded from Therapeutic Hypothermia. Design: A literature review was undertaken of research that considered Therapeutic Hypothermia use outside of the standard criteria. Data sources: Multiple databases formed part of a purposive search, alongside the open grey network, clinical trials network, Cochrane reviews, NICE guidance and National Institute for Health Research and local guidance. Findings: Five papers were reviewed, discussing Therapeutic Hypothermia after 6 h of age, infants with a syndromic diagnosis, late preterm infants (34–35weeks), post-natal collapse, surgical and cardiac infants and infants with major cranial haemorrhage. Overall the findings of the review are encouraging except for cohorts with cranial haemorrhage or syndromic diagnoses.

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