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Major concerns about late hypothermia study
Author(s) -
Walløe Lars,
Hjort Nils Lid,
Thoresen Marianne
Publication year - 2019
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14640
Subject(s) - medicine , hypothermia , encephalopathy , pediatrics , neonatal encephalopathy , bayley scales of infant development , randomized controlled trial , anesthesia , surgery , cognition , psychiatry , psychomotor learning
An important neonatal hypothermia (HT) trial on hypoxic-ischemic-encephalopathy was published in November 2017 by Laptook and the NICHD group (1). One hundred and sixty-eight newborn term infants who failed the 6 hour time-window for HT were recruited by 21 centers over an 8 year period into a trial of HT versus normothermia (NT) if they were >6h and <24 hours old. The median postnatal age at start of HT was 16 hours. The infants were cooled for 96 hours, 24 hours longer than the standard 72 hour duration. Survivors were examined at 18-22 months using the Bayley Scales of Infant Development III and a neurological examination. Outcome data were available for 157 infants including 18 who died (78 HT - 19 with poor outcome, 79 NT - 22 with poor outcome). Clearly, any outcome difference between the HT and NT groups must be small, and not significant (p≈0.75). However, the authors conclude, based on Bayesian analyses, that "among term infants with hypoxic-ischemic encephalopathy hypothermia initiated at 6 to 24 hours after birth compared with noncooling resulted in a 76% probability of any reduction in death or disability". This article is protected by copyright. All rights reserved.