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Neonatal therapeutic hypothermia

Taha Ben Saad

Neonatal Hypoxic ischemic encephalopathy (HIE) has been associated with a high risk for long term morbidity and mortality. HIE occurs in one to three per 1000 live births in high income countries, and up to 20 per 1000 live births in low-and middleincome countries. The pathophysiology of HIE includes a cascade of events resulting in oxidative injury and cell death. Therapeutic hypothermia is a protective therapy, inhibiting various events in the cascade of injury. Therapeutic Hypothermia (Selective Head Cooling or Total Body Cooling) should be initiated within six hours. Studies showed that infants who were started on therapeutic hypothermia within the first six hours after birth, have significantly less morbidity and mortality, and improved long-term neurological outcomes. Therapeutic Hypothermia is now widely offered as standard of treatment for neonatal encephalopathy in high income countries, but it?s still a challenge in middle-and low-income countries.