Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Aug 15;26(8):803-810.
doi: 10.7499/j.issn.1008-8830.2401031.

[Efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy: a prospective randomized controlled study]

[Article in Chinese]
Jie Huang  1 , Ya-Ling Ding  1 , Liang Gao  1 , Yao Zhu  1 , Ya-Yin Lin  1 , Xin-Zhu Lin  1
Affiliations
Randomized Controlled Trial

[Efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy: a prospective randomized controlled study]

[Article in Chinese]
Jie Huang et al. Zhongguo Dang Dai Er Ke Za Zhi. .

Abstract
in English, Chinese

Objectives: To investigate the efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy (HIE).

Methods: A prospective study was performed on 153 neonates with mild HIE who were born from September 2019 to September 2023. These neonates were randomly divided into two groups: therapeutic hypothermia (n=77) and non-therapeutic hypothermia group (n=76). The short-term clinical efficacy of the two groups were compared. Barkovich scoring system was used to analyze the severity of brain injury shown on magnetic resonance imaging (MRI) between the two groups.

Results: There were no significant differences in gestational age, gender, birth weight, mode of birth, and Apgar score between the therapeutic hypothermia and non-therapeutic hypothermia groups (P>0.05). There were no significant differences in the incidence rates of sepsis, arrhythmia, persistent pulmonary hypertension and pulmonary hemorrhage and the duration of mechanical ventilation within the first 72 hours after birth between the two groups. The therapeutic hypothermia group had longer prothrombin time within the first 72 hours after birth and a longer hospital stay (P<0.05). Compared with the non-therapeutic hypothermia group, the therapeutic hypothermia group had lower incidence rates of MRI abnormalities (30% vs 57%), moderate to severe brain injury on MRI (5% vs 28%), and watershed injury (27% vs 51%) (P<0.05), as well as lower medium watershed injury score (0 vs 1) (P<0.05).

Conclusions: Therapeutic hypothermia can reduce the incidence rates of MRI abnormalities and watershed injury, without obvious adverse effects, in neonates with mild HIE, suggesting that therapeutic hypothermia may be beneficial in neuroprotection in these neonates.

目的: 探讨亚低温对新生儿轻度缺氧缺血性脑病（hypoxic-ischemic encephalopathy, HIE）的治疗效果。方法: 前瞻性纳入2019年9月—2023年9月出生的153例轻度HIE新生儿，随机分为亚低温组（77例）和非亚低温组（76例），比较两组的短期临床效果，并采用Barkovich评分系统分析两组患儿磁共振成像（magnetic resonance imaging, MRI）上脑损伤的严重程度。结果: 亚低温组和非亚低温组胎龄、性别、出生体重、Apgar评分等基线资料的比较差异无统计学意义（P>0.05）。两组生后72 h内败血症、心律失常、持续性肺动脉高压、肺出血的发生率及机械通气时间的比较差异无统计学意义（P>0.05）。亚低温组住院时间及生后72 h内凝血酶原时间长于非亚低温组（P<0.05）。与非亚低温组相比，亚低温组MRI异常发生率（30% vs 57%）、MRI中重度脑损伤发生率（5% vs 28%）、分水岭损伤发生率（27% vs 51%）及中位分水岭损伤评分（0 vs 1）均较低（P<0.05）。结论: 新生儿轻度HIE患儿进行亚低温治疗可降低MRI异常发生率和分水岭损伤发生率，且未见明显不良反应，提示新生儿轻度HIE患儿进行亚低温治疗可能在神经保护方面获益。.

Keywords: Brain injury; Brain magnetic resonance imaging; Hypoxic-ischemic encephalopathy; Neonate; Therapeutic hypothermia.

PubMed Disclaimer

Conflict of interest statement

所有作者声明不存在任何利益冲突。

References

    1. Papazian O. Neonatal hypoxic-ischemic encephalopathy[J]. Medicina (B Aires), 2018, 78 (Suppl 2): 36-41. - PubMed
    1. Sun YJ, Zhang ZY, Fan B, et al. . Neuroprotection by therapeutic hypothermia[J]. Front Neurosci, 2019, 13: 586. DOI: 10.3389/fnins.2019.00586. - DOI - PMC - PubMed
    1. 曹长青, 李宇宁, 杨学梅, 等. 亚低温治疗新生儿缺氧缺血性脑病远期临床效果的Meta分析[J]. 中国当代儿科杂志, 2015, 17(2): 122-127. DOI: 10.7499/j.issn.1008-8830.2015.02.003. - DOI - PubMed
    1. 中华医学会儿科学分会新生儿学组, 中华儿科杂志编辑委员会 . 亚低温治疗新生儿缺氧缺血性脑病专家共识（2022）[J]. 中华儿科杂志, 2022, 60(10): 983-989. DOI: 10.3760/cma.j.cn112140-20220418-00344. - DOI - PubMed
    1. Kasdorf E, Laptook A, Azzopardi D, et al. . Improving infant outcome with a 10 min Apgar of 0[J]. Arch Dis Child Fetal Neonatal Ed, 2015, 100(2): F102-F105. DOI: 10.1136/archdischild-2014-306687. - DOI - PubMed

Publication types

LinkOut - more resources