Brain Temperature Is Increased During the First Days of Life in Asphyxiated Newborns: Developing Brain Injury Despite Hypothermia Treatment

Abstract

BACKGROUND AND PURPOSE:Therapeutic hypothermia is the current treatment for neonates with hypoxic-ischemic encephalopathy. It is believed to work by decreasing the brain temperature and reducing the baseline metabolism and energy demand of the brain. This study aimed to noninvasively assess brain temperature during the first month of life in neonates with hypoxic-ischemic encephalopathy treated with hypothermia.

Brain temperature monitoring in newborn infants: Current methodologies and prospects

“…Findings also suggest that infants with MRI evidence of injury had overall higher and more homogenous brain temperature than those without injury ( 97 ). Non-homogenous patterns of brain temperature were also shown in other studies ( 50 – 66 ). In infants developing brain injury after NE, hypothermia decreased brain temperature during the first days of life but did not prevent an early increase of brain temperature ( 66 ).…”

“…Non-homogenous patterns of brain temperature were also shown in other studies ( 50 – 66 ). In infants developing brain injury after NE, hypothermia decreased brain temperature during the first days of life but did not prevent an early increase of brain temperature ( 66 ). Wu et al found significantly higher temperatures and brain-rectal temperature gradients in neonates with NE during TH ( 49 ).…”

“…Costeffective (97). Non-homogenous patterns of brain temperature were also shown in other studies (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66). In infants developing brain injury after NE, hypothermia decreased brain temperature during the first days of life but did not prevent an early increase of brain temperature (66).…”

“…In-vivo MRS temperature measurement has been reported using both single voxel methods (49,50,59, 63, 64) and spectroscopic imaging (65)(66)(67)(68). A challenge for both types of methods is obtaining a good shim to make the magnetic field as uniform as possible and thus minimise the water and metabolite linewidths.…”

Therapeutic Hypothermia

“…In the NICHD NRN childhood follow up data, the association with elevated temperature and death or IQ <70 was still present 30 . Brain temperature measured with magnetic resonance spectroscopy reveals a higher temperature among cooled infants with brain injury on magnetic resonance imaging (MRI) compared to cooled infants without brain injury on MRI 31 . Therefore it is important to avoid and treat elevations of temperature prior to and after TH.…”