Is Selective Head Cooling Combined with Whole-Body Cooling the Most Effective Hypothermia Method for Neonatal Hypoxic-Ischemic Encephalopathy?
Is Selective Head Cooling Combined with Whole-Body Cooling the Most Effective Hypothermia Method for Neonatal Hypoxic-Ischemic Encephalopathy?
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DOI：
10.1089/ther.2022.0021
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发表时间：
2022-10-11
影响因子：
1.2
通讯作者：
Teke, Selcuk
中科院分区：
文献类型：
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作者：
Celik, Yalcin;Ozgur, Anil;Teke, Selcuk
本研究旨在将联合低温 (CH) 与两种经典治疗性低温 (TH) 方法进行比较：选择性头部冷却 (SHC) 和全身冷却 (WBC)。这项回顾性队列研究包括 2012 年至 2020 年间接受 CH、SHC 和 WBC 的新生儿。CH 组通过冷却头部和身体将平均直肠温度维持在 33.5 +/- 0.5 摄氏度，SHC 组通过冷却头部维持在 34.5 +/- 0.5 摄氏度，WBC 组通过冷却身体维持在 33.5 +/- 0.5 摄氏度。比较各组的副作用、磁共振成像 (MRI) 评分和出院时的状态。该研究包括 CH 组 60 名新生儿、WBC 组 112 名新生儿和 SHC 组 27 名新生儿。各组之间的副作用没有显着差异（p > 0.05）。各组间脑MRI评分无显着差异（p>0.05）；然而，CH 组的灰质、白质和 MRI 总评分低于 WBC 组。 CH 组的住院时间短于其他两组 (p = 0.022)。 CH 并不比两种经典 TH 方法产生更多副作用。此外，其中一些研究结果表明，CH 可能比两种经典 TH 方法产生更好的临床结果。
This study aimed to compare combined hypothermia (CH) to the 2 classical therapeutic hypothermia (TH) methods selective head cooling (SHC) and whole-body cooling (WBC). This retrospective cohort study included neonates who underwent CH, SHC, and WBC between 2012 and 2020. Mean rectal temperature was maintained at 33.5 +/- 0.5 degrees C by cooling the head and the body in the CH group, at 34.5 +/- 0.5 degrees C by cooling the head in the SHC group, and at 33.5 +/- 0.5 degrees C by cooling the body in the WBC group. The groups were compared in terms of side effects, magnetic resonance imaging (MRI) scores, and status at discharge. The study included 60 neonates in the CH group, 112 in the WBC group, and 27 in the SHC group. There was no significant difference in side effects between the groups (p > 0.05). There was no significant difference in brain MRI scores between the groups (p > 0.05); however, gray matter, white matter, and total MRI scores in the CH group were lower than in the WBC group. Duration of hospitalization was shorter in the CH group than in the other two groups (p = 0.022). CH was not associated with more side effects than the two classical TH methods. In addition, some of these findings suggest that CH might result in better clinical outcome than the two classical TH methods.