Objective: Several clinical trials evaluating the efficacy of hypothermia in neonates with encephalopathy have shown significant reduction in death and disability at 18-month follow-up. We sought to: 1) evaluate how the use of hypothermia for neonatal hypoxic ischemic encephalopathy (HIE) is changing in U.S. clinical practice, 2) determine which methods and devices for delivering hypothermia ar...

Hypoxic ischemic encephalopathy is a serious condition affecting newborn infants which can result in death and disability. There is now strong clinical evidence that moderate post-asphyxial total body cooling or hypothermia in full term neonates results in long-term neuroprotection, allowing us to proclaim this innovative therapy as "standard of care." The treatment is a time-critical emergency...

OBJECTIVE Therapeutic hypothermia (TH) for neonatal encephalopathy is becoming widely available in clinical practice. The goal of this collaborative was to create and implement an evidence-based standard-of-care approach to neonatal encephalopathy, deliver consistent care, and optimize outcomes. METHODS The quality improvement process identified and used the Model for Improvement as a framewo...

AIM Neuroprotection trials for neonatal encephalopathy use moderate or severe disability as an outcome, with the Bayley Scales of Infant Development, Second Edition (Bayley-2) Index scores of <70 as part of the criteria. The Bayley Scales of Infant and Toddler, 3rd Development, Third Edition (Bayley-3) have superseded Bayley-2 and yield higher than expected scores in typically developing and hi...

Trials in developed countries have shown that therapeutic hypothermia reduces the risk of death or severe disability in infants with neonatal encephalopathy. Cooling has been adopted as a standard of care in some parts of the world. Some Indian neonatal units have considered or even embarked upon cooling encephalopathic term newborn infants. In this article we discuss some of the potential ethi...

Hypothermia treatment neuroprotects approximately 50% of neonates who present with moderate to severe hypoxic ischemic encephalopathy (HIE). N-acetylcysteine (NAC), a potent antioxidant, is neuroprotective in combination with hypothermia in neonatal hypoxia-ischemia (HI) female rats, but less protective in males. Vitamin D is a neurosteroid, which may provide immunomodulation and improve outcom...

It remains controversial as to whether neonatal seizures have additional direct effects on the developing brain separate from the severity of the underlying encephalopathy. Using data collected from infants diagnosed with hypoxic-ischemic encephalopathy, and who were enrolled in an National Institute of Child Health and Human Development trial of hypothermia, we analyzed associations between ne...

Background: Therapeutic hypothermia has become an established protocol for all neonates with moderate to severe Hypoxic Ischaemic Encephalopathy (HIE). There are very few studies comparing the neurodevelopmental outcomes in asphyxiated neonates who received therapeutic hypothermia or did not. This study aimed to assess the neurodevelopmental outcomes of asphyxiated neonates with features of HIE...