The Indian Journal of Pediatrics

, Volume 79, Issue 10, pp 1342–1346 | Cite as

The Efficacy of Hypothermia in Hypoxic-Ischemic Encephalopathy at 18 Mo or More

  • Li Wu
  • Bin Yi
  • Yang Hu
  • Cunwei Ji
  • Tao Zhang
  • Youjie Wang
Original Article

Abstract

Objective

To evaluate the efficacy of hypothermia in the treatment of hypoxic-ischemic encephalopathy (HIE) in neonates at 18 mo of age or more. Also to examine whether the severity of encephalopathy affects the efficacy of hypothermia on mortality and neurodevelopmental disability.

Methods

The authors recruited the trials that assessed the efficacy of therapeutic hypothermia in the treatment of HIE in neonates at 18 mo of age or older up to April 2011. The meta- analysis was performed using a fixed effect model.

Results

Hypothermia significantly reduced the combined rate of death or neurodevelopmental disability (RR = 0.74, 95% CI: 0.67 to 0.82; RD = −0.13, 95% CI: −0.18 to −0.08; NNT = 7, 95% CI: 6 to 9) among infants at 18 mo of age or older. Hypothermia reduced the rate of death (RR = 0.75, 95% CI: 0.64 to 0.88), neurodevelopmental disability (RR = 0.65, 95% CI: 0.54 to 0.79), cerebral palsy (RR = 0.65, 95% CI: 0.53 to 0.80), developmental delay (RR = 0.72, 95% CI: 0.57 to 0.92), neuromotor delay (RR = 0.78, 95% CI: 0.61 to 0.99) and visual deficit (RR = 0.59, 95% CI: 0.36 to 0.99). Analysis of the severity of disease showed that hypothermia reduced the combined rate of death or neurodevelopmental disability not only in moderate encephalopathy infants (RR = 0.63, 95% CI: 0.53 to 0.76) but also in severe encephalopathy infants (RR = 0.82, 95% CI: 0.74 to 0.92).

Conclusions

Hypothermia has a beneficial effect in the treatment of HIE in neonates at 18 mo of age or older.

Keywords

Hypothermia Hypoxic-ischemic encephalopathy Neonate Efficacy 

Abbreviations

HIE

Hypoxic-Ischemic Encephalopathy

SHC

Selective Head Cooling

WBC

Whole Body Cooling

CI

Confidence Interval

RR

Relative Risk

RD

Risk Difference

NNT

Number Needed to Treat

Notes

Acknowledgements

The authors thank Dr. Zhang (Southeast University) for providing them with additional data. They also thank Dr Liang (Tongji Medical College, Huazhong University of Science & Technology) for providing statistical advice.

Contributions

YW: study design and manuscript drafting; LW: writing the manuscript; YH: analyzing the data; BY, YW: evaluating the methodological quality of the recruited studies; CJ and LW: collecting the data.

Conflict of Interest

None.

Role of Funding Source

National Natural Science Foundation of China, Project No: 30671733, and NECT Program 07-0333.

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Copyright information

© Dr. K C Chaudhuri Foundation 2012

Authors and Affiliations

  • Li Wu
    • 1
  • Bin Yi
    • 2
  • Yang Hu
    • 1
  • Cunwei Ji
    • 1
  • Tao Zhang
    • 1
  • Youjie Wang
    • 1
  1. 1.Department of Maternal and Child HealthTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
  2. 2.Department of NeonatologyMaternal and Children Hospital of Gansu ProvinceLanzhouChina

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