Use of therapeutic hypothermia in neonates with hypoxic ischemic encephalopathy: a literature review

Abstract

Objectives: Expose basic concepts of the existing literature on induced hypothermia in newborns who evolved with hypoxic-ischemic encephalopathy. Methods: A narrative literature review was carried out based on 22 articles, from February to April 2023, prioritizing articles published in the last 5 years. The articles were taken from the Lilacs, Pubmed, Scielo, Embase and Scopus databases. Results: Hypoxic-ischemic encephalopathy (HIE) consists of a series of cellular and molecular alterations resulting from a severe anoxic brain injury that occurred in the neonatal period. Current research reveals that even the condition in its mild form is not benign. Therapeutic Hypothermia (TH) is the most effective technique indicated for the management of newborns (NB) admitted to the Neonatal Intensive Care Unit (NICU) who present neuropathies secondary to asphyxia, accompanied by clinical signs of Hypoxic-Ischemic Encephalopathy. The therapy consists of exposing the newborn at term or late preterm to a temperature of 33.5º C from the first 6 hours of life and, over 72 hours of cooling, gradually rewarming the patient. Total body hypothermia, when compared with the control group to identify the outcome of neurological abnormalities, contributed to a 17% reduction. Concomitantly with these data, found at 18 months of age, there was also a 21% reduction in the risk of cerebral palsy and a 22% reduction in moderate or severe disability. Conclusion: It has been shown that induced hypothermia can be effective in reducing mortality and neurodevelopmental failures in these newborns.