Until now, brain MRIs in asphyxiated neonates who are receiving therapeutic hypothermia have been performed after treatment is complete. However, there is increasing interest in utilizing early brain MRI while hypothermia is still being provided to rapidly understand the degree of brain injury and possibly refine neuroprotective strategies. This study was designed to assess whether therapeutic hypothermia can be maintained while performing a brain MRI. Twenty MRI scans were obtained in 12 asphyxiated neonates while they were treated with hypothermia. The median difference between esophageal temperature on NICU departure and return was 0.1°C (range: −0.8 to 0.8°C). We found that therapeutic hypothermia can be safely and reproducibly maintained during a brain MRI. Hypothermia treatment should not prevent obtaining an early brain MRI if clinically indicated.
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Pia Wintermark receives generous research grant funding from the William Randolph Hearst Fund Award and the Thrasher Research Fund Early Career Award Program. The work of Simon K. Warfield is supported by NIH grants R01 RR021885, R01 GM074068, R03 EB008680 and P30 HD018655. The authors thank the families and their neonates for participating in the study. A special thank-you is also expressed to the NICU clinicians and the MRI technicians who made this study possible.
Conflicts of interest
No conflict of interest. The mention of specific vendors for equipment is solely reflective of equipment usage in our unit. We do not receive any financial or other compensation from any of the vendors mentioned in this review. We realize that there are other vendors who manufacture MR-compatible equipment.
Eicher DJ, Wagner CL, Katikaneni LP et al (2005) Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr Neurol 32:11–17CrossRefPubMedGoogle Scholar
Gluckman PD, Wyatt JS, Azzopardi D et al (2005) Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 365:663–670PubMedGoogle Scholar
Shankaran S, Laptook AR, Ehrenkranz RA et al (2005) National Institute of Child Health and Human Development Neonatal Research Network. Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 353:1574–1584CrossRefPubMedGoogle Scholar
Jacobs S, Hunt R, Tarnow-Mordi W et al (2007) Cooling for newborns with hypoxic-ischaemic encephalopathy. Cochrane Database Syst Rev 4:CD003311PubMedGoogle Scholar
Azzopardi D, Brocklehurst P, Edwards D et al (2008) Whole body hypothermia for the treatment of perinatal asphyxial encephalopathy: a randomised controlled trial. BMC Pediatr 8:17CrossRefPubMedGoogle Scholar
Azzopardi DV, Strohm B, Edwards AD et al (2009) Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med 361:1349–1358CrossRefPubMedGoogle Scholar
Inder TE, Hunt RW, Morley CJ et al (2004) Randomized trial of systemic hypothermia selectively protects the cortex on MRI in term hypoxic-ischemic encephalopathy. J Pediatr 145:835–837CrossRefPubMedGoogle Scholar
Rutherford MA, Azzopardi D, Whitelaw A et al (2005) Mild hypothermia and the distribution of cerebral lesions in neonates with hypoxic-ischemic encephalopathy. Pediatrics 116:1001–1006CrossRefPubMedGoogle Scholar
Rutherford M, Ramenghi LA, Edwards AD et al (2010) Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic-ischaemic encephalopathy: a nested substudy of a randomised controlled trial. Lancet Neurol 9:39–45CrossRefPubMedGoogle Scholar
Higgins RD, Raju TN, Perlman J et al (2006) Hypothermia and perinatal asphyxia: executive summary of the National Institute of Child Health and Human Developmental workshop. J Pediatr 148:170–175CrossRefPubMedGoogle Scholar