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Neonatal Asphyxia

  • Chapter
Therapeutic Hypothermia

Part of the book series: Molecular and Cellular Biology of Critical Care Medicine ((MCCM,volume 4))

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Abstract

Moderate to severe hypoxic-ischemic encephalopathy continues to be an important cause of acute neurologic injury at birth, occurring in approximately 1 to 2 cases per 1000 term live births (1). The possibility that hypothemia might be able to alleviate neonatal brain injury is a ‘dream revisited’. Early experimental studies, mainly in altricial species such as kittens, demonstrated that hypothermia greatly extended the ‘time to last gasp’ and improved outcomes (2). These findings led to a series of small uncontrolled studies in the 1950s and 1960s where infants not breathing spontaneously at five minutes after birth were immersed in cold water until respiration resumed (3–7). Although outcomes were said to be better than for historical controls, this experimental approach was overtaken by two major developments: the introduction of active ventilation of infants exposed to asphyxia and the recognition that even mild hypothermia is associated with increased oxygen requirements and greater mortality in the premature newborn (8). Thus resuscitation guidelines for the newborn exposed to asphyxia have, until very recently, simply emphasized prevention of hypothermia.

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Authors and Affiliations

  1. University of Auckland, Auckland, NZ

    Alistair J. Gunn MBChB, PhD & Laura Bennet PhD

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  1. Alistair J. Gunn MBChB, PhD
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Editors and Affiliations

  1. Department of Critical Care, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Samuel A. Tisherman MD

  2. Emergency Medicine, Medical University of Vienna, 1090, Vienna, Austria

    Fritz Sterz MD

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Gunn, A.J., Bennet, L. (2005). Neonatal Asphyxia. In: Tisherman, S.A., Sterz, F. (eds) Therapeutic Hypothermia. Molecular and Cellular Biology of Critical Care Medicine, vol 4. Springer, Boston, MA. https://doi.org/10.1007/0-387-25403-X_9

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