The article written by Edwards and Azzopadi1 is excellent. Whole‐body hypothermia is proving to be the treatment of choice for neonates with perinatal asphyxia. 2,3 Not only is there benefit to the babies aged 18 months4 but it is beneficial in the neonatal period also. We, at Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India, studied 20 neonates with severe perinatal asphyxia who received whole body hypothermia and 15 neonates who served as controls. Randomisation was carried out by computer‐generated random numbers. In babies with hypothermia, skin and rectal temperatures were maintained at 33.5°C for 72 h followed by slow re‐warming. The study aimed at looking for death or abnormal neurological examination at the time of discharge. Although there were no significant differences between the patients who died in the two groups (15% .v. 33%, p>0.05), hypothermic neonates were less likely to have abnormal neurological examination at discharge (p<0.001). The study shows that whole‐body hypothermia can be beneficial in the immediate neonatal period and, in combination with other treatments, can reduce the chances of having neurodevelopmental delay in babies aged 18 months.
Footnotes
Competing interests: None declared.
References
- 1.Edwards A D, Azzopadi D V. Therapeutic hypothermia following perinatal asphyxia. Arch Dis Child Fetal Neonatal Ed 200691F127–F131. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Eicher D J, Wagner C L, Katikaneni L P.et al Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr Neurol 20053211–17. [DOI] [PubMed] [Google Scholar]
- 3.Shankaran S, Laptook A R, Ehrenkranz R A.et al Whole‐body hypothermia for neonates with hypoxic‐ischemic encephalopathy. N Engl J Med 20053531574–1584. [DOI] [PubMed] [Google Scholar]
- 4.Gluckman P D, Wyatt J S, Azzopadi D.et al Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 2005365663–670. [DOI] [PubMed] [Google Scholar]