Therapeutic hypothermia for neonatal encephalopathy implications for neonatal units in India

Sudhil Thayyil, Anthony Costello, Seetha Shankaran, Nicola Jayne Robertson

Research output: Contribution to journalReview articlepeer-review

Abstract

Therapeutic hypothermia has recently emerged from bench to bedside. Three large multicenter trials from industrialized countries and three independent meta-analyses have shown its efficacy in reducing death and disability following neonatal encephalopathy due a perinatal hypoxic event. Many neonatal units in well-resourced settings now offer hypothermia as standard care in neonatal encephalopathy. However, these results cannot be extrapolated to low resource settings due to differences in population, risk benefits and high cost. Use of therapeutic hypothermia in low resource settings should be considered experimental and should therefore be restricted to well equipped level 2 and 3 neonatal units. The safety and efficacy of hypothermia using novel low technology methods need to be examined in rigorously controlled multicenter randomized controlled trials in these neonatal units before it can be offered as a standard care, as the risks may outweigh the benefits. The current practice of maintaining normothermia should continue, until such evidence is available.

Original languageEnglish
Pages (from-to)283-9
Number of pages7
JournalIndian Pediatrics
Volume46
Issue number4
Publication statusPublished - Apr 2009

Keywords

  • Brain Diseases/therapy
  • Humans
  • Hypothermia, Induced
  • India
  • Infant, Newborn

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