Neuroprotection with therapeutic hypothermia in hypoxic ischemic encephalopathy in pediatrics

Abstract

Neuroprotection with therapeutic hypothermia in neonates with perinatal hypoxic-ischemic encephalopathy (HIE) has shown to reduce death and disability in the long term. However, apart from perinatal HIE there is still no scientific evidence to suggest that the use of this technique leads to a better prognosis in children who have suffered a cardiac arrest. Several multicenter trials are currently under way in this age group, aiming to demonstrate effect of moderate hypothermia compared to normothermia, and set the duration, depth of hypothermia and rewarming rate.

However, it is a fact that many pediatric intensive care units are performing this treatment based on the latest international cardiopulmonary resuscitation guidelines that recommend the use of therapeutic hypothermia in children, inferring scientific evidence from studies in the adult and neonatal age.

However, to apply treatment with hypothermia, certain conditions should be reached as prior training, ability to adequately monitor the neurological status of the patient and know and provide a comprehensive treatment of potential complications secondary to hypoxic ischemic disease.