Hypoxic–Ischemic Encephalopathy: To Cool, or Not to Cool, That Is the Question

Abstract

An infant was born at 38 weeks' gestation. The assigned Apgar scores were 2, 3, and 5 at 1, 5, and 10 minutes, respectively. The physical examination showed hypotonia, absent gag reflex, and poor response to pain. At 9 hours after birth, the infant was noted to have a subtle seizure and bradypnea. The infant was intubated and started on anticonvulsant therapy. A brain magnetic resonance imaging (MRI) and an electroencephalogram (EEG) were obtained. This report presents the clinical and diagnostic dilemma that is typically associated with decisions needed for treatment with therapeutic hypothermia (TH).

Genetic Testing in Neonatal Hypoxic-Ischemic Encephalopathy

“…We recently had a case where perinatal events were not suggestive of HIE. 2 Therapeutic hypothermia was withheld, but the infant had a seizure creating a debate among the group about therapeutic hypothermia beyond 6 hours without any history of perinatal events. Established therapeutic hypothermia guidelines indicate the inclusion of perinatal events for reasons (acidosis, seizure, and signs of encephalopathy could be due to other neurologic causes).…”

Coordinated Multispecialty Care: A Need for Critically Ill Newborn Infants

“…15 Multiple studies have shown the importance of therapeutic hypothermia (TH) as a treatment modality, but some uncertainty remains. 16,17 Manzar et al 18 describe a full-term infant with low Apgar scores who had a slightly delayed onset of HIE. The paper presents the clinical and diagnostic dilemmas that are typically associated with decisions needed for treatment with TH.Ethawi and coworkers 19 have reviewed the care of infants born to mothers who are suspected/known to have coronavirus disease-19 (COVID-19).…”