Therapeutic Hypothermia in Asphyxiated Neonates with Hypoxic-ischemic Encephalopathy: A single-center Experience from its First Application in Saudi Arabia

Title: Therapeutic Hypothermia in Asphyxiated Neonates with Hypoxic-ischemic Encephalopathy: A single-center Experience from its First Application in Saudi Arabia

Authors: Najia Al Hojaili, Hatem Alomari, Attia Alzahrani, Abdallah Kan, Rasha Mohammad

DOI: http://dx.doi.org/10.18535/jmscr/v4i4.63

Abstract

Background/ Objective: Therapeutic hypothermia has become an accepted therapy in asphyxiated newborns with evidence of moderate to severe hypoxic-ischemic encephalopathy. In this study, it has been described our new experience with the whole body cooling treatment method in asphyxiated neonates. To our knowledge, this is the first relevant report in Saudi Arabia.

Methods: The medical records of all asphyxiated neonates treated with therapeutic hypothermia in Makkah Maternity children hospital between 2013-2015 were retrospectively reviewed. We recorded data related to neonatal-perinatal characteristics, total body cooling method was performed and outcomes.

Results: One hundred and forty asphyxiated neonates [median gestational age 38 weeks ] received total body cooling (rectal temperature 33.5 ± 0.5 ^oC for 72 hours followed by slow re-worming ) during the study period for moderate and severe hypoxic-ischemic encephalopathy. All neonates were depressed upon delivery with median Apgar scores 6 at 10 minutes. Therapeutic hypothermia was initiated at the median age of 6 hours after birth. On follow-up after our cooling method, neurodevelopment outcome was normal in 107 and 83 cases, depending on the evidence of computerized axial tomography (CAT) scan and the absence of clinical seizures after our cooling treatment method.

Conclusions: Our initial experience with total body cooling treatment method supports its beneficial effect as safe and effective in asphyxiated newborns. This treatment should be offered in all centers involved in the care of such neonates using our simple method.

Keywords: neonatal encephalopathy, neonatal care, perinatal asphyxia, total body cooling method, Saudi Arabia.

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Corresponding Author

Dr Najia Al Hojaili

Consultant Neonatologist, MOH, B O pox 8981, Makkah Al-Mokarramah Saudi Arabia

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