Therapeutic hypothermia: Does it benefit newborns with Hypoxic-ischaemic encephalopathy?

Current supportive therapy for Hypoxic-ischaemic encephalopathy (HIE) has made very little changes in the neurodevelopmental outcome of the survivors. Cerebral hypothermia after hypoxicischaemic insult is an important neuroprotective strategy that has emerged during the past decade and this can be achieved by cooling the head selectively or by whole-body cooling. Several clinical studies have shown that mild hypothermia is generally safe in the short-term, when used under strict experimental protocols and in intensive care setting. Randomized controlled trials in term and near-term infants with HIE have shown that mild therapeutic hypothermia is associated with a significant reduction of combined outcome of death or disability in infants studied between 12 and 22 months. There is insufficient information to determine whether one method of cooling is more effective than the other. But there are major gaps in our understanding that still need to be addressed and the long-term safety and efficacy of cooling therapy has not been established. More research is needed before intervention with therapeutic mild hypothermia can be recommended as a standard care in the management of severely asphyxiated newborn infants.