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Cooling Can Reduce Neurologic Damage in Perinatal Asphyxia

Last Updated: September 30, 2009.

Reducing the body temperature of newborn infants who have perinatal asphyxia encephalopathy did not reduce the rates of death or severe disability, but lessened the neurologic damage among survivors, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

WEDNESADY, Sept. 30 (HealthDay News) -- Reducing the body temperature of newborn infants who have perinatal asphyxia encephalopathy did not reduce the rates of death or severe disability, but lessened the neurologic damage among survivors, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

Denis V. Azzopardi, of Imperial College London, and colleagues conducted the Total Body Hypothermia for Neonatal Encephalopathy Trial (TOBY), in which 325 newborn infants with the condition were randomized to receive intensive care alone (162 subjects) or intensive care with cooling to 33.5 degrees Celsius for 72 hours (163 subjects). The main outcomes were death or severe disability at 18 months, while secondary outcomes included 12 neurologic and 14 adverse outcomes (hemorrhaging, hypotension, and others).

In the study group, the researchers report that 42 infants died and 32 had severe disability, compared to 44 and 42, respectively, in the control group; adverse events were similar in both groups. However, the study group had a higher rate of survival without neurologic disability (44 percent) compared to the control group (28 percent), and scored better on the scores of infant development and gross motor function compared to the control group.

"In conclusion, TOBY did not show a significant reduction in the combined rates of death and severe disability with cooling, as compared with no cooling, but did show a significant improvement in several secondary neurologic outcomes among survivors," the authors write.

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