Mild hypothermia via selective head cooling as neuroprotective therapy in term neonates with perinatal asphyxia: an experience from a single neonatal intensive care unit

J Perinatol. 2006 Mar;26(3):180-4. doi: 10.1038/


Objective: The objective of this study was to determine the efficacy of mild hypothermia via selective head cooling as a neuroprotective therapy in term infants with perinatal asphyxia.

Study design: Full-term newborns who had 5 min Apgar scores <6, first arterial blood gas pH<7.10 or BD>15 mEq/l, and with the clinical signs of encephalopathy were enrolled within 6 h after birth. Patients were randomized to receive mild hypothermia treatment via selective head cooling for a total of 72 h or receive routine treatment as a control. Brain hypoxic-ischemic injury was quantified based on the head computed tomographic scan (CT scan) at postnatal age 5-7 days and a Neonatal Behavioral Neurological Assessment (NBNA) score at 7-10 days of life.

Results: A total of 58 patients (30 hypothermia, 28 control) completed the study. Hypothermia was well tolerated in this study and attenuated the hypoxic-ischemic brain injury due to perinatal asphyxia. Head CT scan demonstrated moderate to severe hypoxic-ischemic changes in only 4/30 cases from the hypothermic group. In contrast, 18/28 cases in the control group showed moderate to severe hypoxic-ischemic changes (chi (2)=15.97, P<0.01). Brain hypothermia also significantly improved the NBNA score (32+/-2 in the hypothermic group vs 28+/-3 in the control group, P<0.01).

Conclusions: Our results suggest that selective head cooling may be used as a neuroprotective therapy in term neonates with perinatal asphyxia. A long-term follow-up study is needed to further validate the results of this study.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Apgar Score
  • Asphyxia Neonatorum / diagnosis*
  • Asphyxia Neonatorum / therapy*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Hypothermia, Induced / methods*
  • Hypoxia, Brain / prevention & control*
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Male
  • Pregnancy
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome