Therapeutic Hypothermia in Perinatal Encephalopathy: Do Depth and Duration of Cooling Matter?

Results of several trials have established that 72 hours of therapeutic hypothermia at 33^oC to 34^oC reduces neurodevelopmental disability for term and near-term infants with moderate or severe encephalopathy. However, half of children who are cooled still die or survive with impairments, which has led to interest in optimizing the method of cooling.

In the current study, investigators enrolled 364 infants who met standard criteria for cooling (perinatal acidosis and clinical findings of encephalopathy). Using a 2×2 factorial design, infants were randomized to a cooling temperature of 33.5^oC or 32.0^oC and to a cooling duration of 72 hours or 120 hours. The study ended after enrollment of 364 neonates at the recommendation of the data and safe…