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Archivos de Pediatría del Uruguay
Print version ISSN 0004-0584On-line version ISSN 1688-1249
Abstract
SILVERA, Fernando. Hipotermia en recién nacidos con asfixia perinatal . Arch. Pediatr. Urug. [online]. 2011, vol.82, n.3, pp.147-158. ISSN 0004-0584.
Summary Controlled hypothermia has been shown to reduce death or severe disability, mortality and neurodevelopment disorders in infants who have suffered perinatal asphyxia. In order to implement the achievement of hypothermia the application was analyzed in 10 infants that met inclusion criteria in two medical centers in Montevideo. Target temperature (33,5°C) was reached within 6 hours of life of patients and was kept in that range for 72 hours in 7 / 10 patients. In 8/10 patients a cap with circulating cold water and 2/10 frozen gel plates were used for direct brain cooling and whole body. Three patients withdrew from the protocol after 48 hours of hypothermia due to clotting problems, severe bradycardia and cardiorespiratory arrest respectively. The warming was achieved in all cases within six hours. 60% of patients had seizures during hospitalization and 100% received phenobarbital. In the study group two patients died. In addition a newborn pig model shows the impact of severe hypoxia and induction of hypothermia on the most relevant variables. We conclude that the development of controlled hypothermia is a feasible and safe therapeutic strategy that provides an opportunity for patients who have suffered perinatal asphyxia
Keywords : ASPHYXIA NEONATORUM; HYPOTHERMIA, INDUCED; HYPOXIA-ISCHEMIA, BRAIN; INFANT, NEWBORN.