Therapeutic hypothermia in newborns with hypoxic-ischemic encephalopathy: An analysis of early childhood

Authors

DOI:

https://doi.org/10.33448/rsd-v12i2.40056

Keywords:

Hypoxic-ischemic encephalopathy; Induced hypothermia; Child mortality; Neurodevelopmental disorder.

Abstract

Objective: To carry out a critical analysis of the results of the use of therapeutic hypothermia (HT) in newborns (NBs) affected with hypoxic-ischemic encephalopathy (HIE), with emphasis on mortality and neurodevelopment outcomes during early childhood. Methodology: This is a systematic review carried out through searches in the indexed platforms: PubMed, Lilacs, Cochrane and BVS, using the descriptors in English: “effects”, “hypoxic-ischemic encephalopathy” and “induced hypothermia”, separated by the Boolean operator (AND). Complete clinical trial articles were included, in Portuguese or English, published between 2012 and 2022, whose target population consisted of NBs, of both sexes, diagnosed with neonatal hypoxia or HIE, who underwent treatment with TH. Furthermore, only articles that emphasized mortality and neurodevelopmental outcomes from discharge to early childhood were selected. Results: The present study had a final sample of 4 articles. Through the analysis of the selected studies, it was noticed that TH acts through neuroprotection mechanisms, favoring the inhibition of the inflammatory cascade induced during the development process of HIE, helping to reduce brain injury and consequently decreasing the rates of morbidity and mortality of patients affected with HIE, contributing to the full development of children. Conclusion: The neuroprotective effect of TH is capable of reducing the presence of neurological sequelae and decreasing mortality rates in the pediatric/neonatal population affected by HIE.

References

Abate, B. B., Bimerew, M., Gebremichael, B., Mengesha Kassie, A., Kassaw, M., Gebremeskel, T., & Bayih, W.A. (2021). Effects of therapeutic hypothermia on death among asphyxiated neonates with hypoxic-ischemic encephalopathy: a systematic review and metaanalysis of randomized control trials. PLoS One, 25;16(2). doi:10.1371/journal.pone.0247229.

Aker, K., Støen, R., Eikenes, L., Martinez-Biarge, M., Nakken, I., Håberg, A. K., Gibikote, S., & Thomas, N. (2020). Therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy in India (THIN study): a randomised controlled trial. Arch Dis Child Fetal Neonatal, 105(4):405-411. doi:10.1136/archdischild-2019-317311.

Balasundaram, P., & Avulakunta, I.D. (2022). Bayley Scales Of Infant and Toddler Development. Rockville Pike, Estados Unidos: StatPearls.

Bharadwaj, S.K., & Bhat, B.V. (2012). Therapeutic hypothermia using gel packs for term neonates with hypoxic ischaemic encephalopathy in resource-limited settings: a randomized controlled trial. J Trop Pediatr, 58(5):382-8. doi:10.1093/tropej/fms005.

Black, M. M., Walker, S. P., Fernald, L. C. H., Andersen, C. T., Digirolamo, A. M., Lu, C., Mccoy, D. C., Fink, G., Shawar, Y. R., Shiffman, J., Devercelli, A. E., Wodon, Q. T., Vargas-Barón, E., & Grantham-Mcgregor, S. (2017). Early childhood development coming of age: science through the life course. Lancet, 389(10064):77-90. doi:10.1016/S0140-6736(16)31389-7.

Catherine, R. C., Ballambattu, V.B., Adhisivam, B., Bharadwaj, S.K., & Palanivel, C. (2021). Effect of Therapeutic Hypothermia on the Outcome in Term Neonates with Hypoxic Ischemic Encephalopathy-A Randomized Controlled Trial. J Trop Pediatr., 29;67(1). doi:10.1093/tropej/fmaa073.

Comitê Científico do Núcleo Ciência Pela Infância. (2014). O Impacto do Desenvolvimento na Primeira Infância sobre a Aprendizagem. Acessado em: 15 de novembro de 2022. Disponível em: https://www.mds.gov.br/webarquivos/arquivo/crianca_feliz/treinamento/multiplicadores_coordenadores/impacto_desenvolvimento_primeirainfancia_sobre_apredizagem.pdf.

Davidson, J. O., Gonzalez, F., Gressens, P., & Gunn, A. J. (2021). Update on mechanisms of the pathophysiology of neonatal encephalopathy. Semin Fetal Neonatal Med, 26(5):101267. doi:10.1016/j.siny.2021.101267.

Drury, P. P., Bennet L., & Gunn, A.J. (2010). Mechanisms of hypothermic neuroprotection. Seminars in fetal & Neonatal Medicine, 15(5):287-92. doi:10.1016/j.siny.2010.05.005.

Edwards, A.D., Brocklehurst, P., Gunn, A.J., Halliday, H., Juszczak, E., Levene, M., Strohm, B., Thoresen, M., Whitelaw, A., & Azzopardi, D. (2010). Neurological outcomes at 18 months of age after moderate hypothermia for hypoxic-ischemic encephalopathy perinatal: synthesis and meta-analysis of study data. BMJ, 340:c363. doi:10.1136/bmj.c363.

França, E. B., LanskyII, S., Rego, M. A. S., Malta, D. C., França, J. S., Teixeira, R., Porto, D., Almeida, M. F., Souza, M. F. M., Szwarcwald, C. L., Mooney, M., Naghavi, M., & Vasconcelos, A. M. N. (2017). Principais causas da mortalidade na infância no Brasil, em 1990 e 2015: estimativas do estudo de Carga Global de Doença. Rev Bras Epidemiol. 20(1):46-60. doi:10.1590/1980-5497201700050005.

Galvão, T. F., & Pereira, M. G. (2014). Revisões sistemáticas da literatura: passos para sua elaboração. Epidemiol. Serv. Saúde, 23(1):183-184. doi:10.5123/S1679-49742014000100018.

Gane, B.D., Bhat, V., Rao, R., Nandhakumar, S., Harichandrakumar, K.T., & Adhisivam, B. (2014). Effect of therapeutic hypothermia on DNA damage and neurodevelopmental outcome among term neonates with perinatal asphyxia: a randomized controlled trial. J Trop Pediatr., 60(2):134-40. doi:10.1093/tropej/fmt098.

Goswami, I., Guillot, M., & Tam, E.W.Y. (2020). Predictors of Long-Term Neurodevelopmental Outcome of Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia. Semin Neurol, 40(3):322-334. doi:10.1055/s-0040-1702939.

Guillet, R., Edwards, A.D., Thoresen, M., Ferriero, D.M., Gluckman, P.D., Whitelaw, A., & Gunn, A.J. (2012). Seven- to eight-year follow-up of the CoolCap trial of head cooling for neonatal encephalopathy. Pediatr Res., 71(2):205-9. doi:10.1038/pr.2011.30.

Harriman, T., Bradshaw, W.T., & Blake, S.M. (2017). The Use of Whole Body Cooling in the Treatment of Hypoxic-Ischemic Encephalopathy. Neonatal Netw, 36(5):273-279. doi:10.1891/0730-0832.36.5.273.

Kishore, M. T., Desai, G., Mahindru, P., Ragesh, G., Thippeswamy, H., Ganjekar, S., & Chandra, P. S. (2018). Baroda development screening test for infants in a perinatal psychiatry setting: A preliminary report from India. Int J Health Allied Sci, 7:246-9. doi:10.4103/ijhas.IJHAS_82_17.

Madaan, P., Saini, L., & Sondhi, V. (2021). Development Assessment Scale for Indian Infants: A Systematic Review and Perspective on Dwindling Cutoffs. Indian J Pediatr, 88(9):918-920. doi:10.1007/s12098-021-03671-2.

Madaschi, V., Mecca, T. P., Macedo, E. C., & Paula, C. S. (2016). Bayley-III Scales of Infant and Toddler Development: Transcultural Adaptation and Psychometric Properties. Paidéia, 26 (64):189-197. Disponível em: https://doi.org/10.1590/1982-43272664201606.

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati A., Petticrew, M., Shekelle, P., Stewart, LA., & PRISMA-P Group (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1): 1. doi: 10.1186/2046-4053-4-1.

Moral, Y., Robertson, N.J., Goni-De-Cerio, F., & Alonso-Alconada, D. (2019). Hipoxia-Isquemia neonatal: bases celulares y moleculares del daño cerebral y modulacíon terapéutica de la neurogênesis. Rev Neurol, 1;68(1):23-36. Disponível: https://doi.org/10.33588/rn.6801.2018255.

Ono, C. M., Bruck, I., Antoniuk, A. S., & Riechi, T. I. J. S. (2011). Valor preditivo de avaliação neurológica no desenvolvimento cognitivo de crianças nascidas pré-termo. Bol. Psicol., 2011, 61(134): 93-102. Disponível em: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S0006-59432011000100008.

Papazian, O. (2018). Encefalopatía hipóxica-isquémica neonatal. Medicina (B Aires), 78 Suppl 2:36-41. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30199363/.

Rech, T.H., & Vieira, S.R.R. (2010). Hipotermia terapêutica em pacientes pós-parada cardiorrespiratória: mecanismos de ação e desenvolvimento de protocolo assistencial. Rev Bras Ter Intensiva, 22(2):196-205. Disponível em: https://doi.org/10.1590/S0103-507X2010000200015.

Silveira, R.C., & Procianoy, R.S. (2015). Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. Jornal de Pediatria, 91(6 Suppl 1):S78-83. doi:10.1016/j.jped.2015.07.004.

Sociedade Brasileira de Pediatria. (2021). Hipotermia Terapêutica. Acessado em: 20 de novembro de 2022. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/22568c-DocCient_- _Hipotermia_Terapeutica.pdf.

Sociedade Catarinense de Pediatria. (2017). Minuto de ouro. Acessado em: 21 de novembro de 2022. Disponível em: http://www.scp.org.br/minuto-de-ouro/.

Sousa, J. R., & Santos, S. C. M. (2020). Análise de conteúdo em pesquisa qualitativa: modo de pensar e de fazer. Pesquisa e Debate em Educação, 10 (2):1396 – 1416. doi: https://doi.org/10.34019/2237-9444.2020.v10.31559.

Sterne, J.A., Hernán, M.A., Reeves, B.C., Savović, J., Berkman, N.D., Viswanathan, M., Henry, D., Altman, D.G., Ansari, M.T., Boutron, I., Carpenter, J.R., Chan, A.W., Churchill, R., Deeks, J.J., Hróbjartsson, A., Kirkham, J., Jüni, P., Loke, Y.K., Pigott, T.D., Ramsay, C.R., Regidor, D., Rothstein, H.R., Sandhu, L., Santaguida, P.L., Schünemann, H.J., Shea, B., Shrier, I., Tugwell, P., Turner, L., Valentine, J.C., Waddington, H., Waters, E., Wells, G.A., Whiting, P.F., & Higgins, J.P. (2016). ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ, 12(355):i4919. doi:10.1136/bmj.i4919.

Sun, J., Li, J., Cheng, G., Sha, B., & Zhou, W. (2012). Effects of hypothermia on NSE and S-100 protein levels in CSF in neonates following hypoxic/ischaemic brain damage. Acta Paediatr., 101(8):e316-20. doi:10.1111/j.1651-2227.2012.02679.

Takazono, P.S., & Golin, O. G. (2012). Asfixia Perinatal: Repercussões Neurológicas e Detecção Precoce. Rev Neurocienc, 1(21):108-117. doi:10.34024/rnc.2013.

Torres, A. R., Naranjo, J. D., Salvador, C., Mora, M., Papazian, O. (2019). Factores predominantes de encefalopatía neonatal: hipoxia e isquemia, um problema global. Medicina (B. Aires), 79(supl.3): 15-19. Disponível em: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76

Published

01/02/2023

How to Cite

PUGA, G. R. .; PIEDADE, A. B. de S. .; CALDAS , L. M. .; MACIEL , F. L. . Therapeutic hypothermia in newborns with hypoxic-ischemic encephalopathy: An analysis of early childhood. Research, Society and Development, [S. l.], v. 12, n. 2, p. e16112240056, 2023. DOI: 10.33448/rsd-v12i2.40056. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/40056. Acesso em: 16 nov. 2024.

Issue

Section

Health Sciences