Therapeutic Hypothermia: When Is It Too Late to Begin?

Therapeutic hypothermia initiated between 6 and 24 hours of life may have small benefit for infants with moderate hypoxic-ischemic encephalopathy.

Several trials have established that for term and near-term infants with moderate or severe encephalopathy, 72 hours of therapeutic hypothermia at 33°C to 34°C, initiated at less than 6 hours of life, reduces neurodevelopmental disability. However, questions remain about whether initiating this therapy beyond the first 6 hours of life has benefit.

Between 2008 and 2014, investigators randomized 168 infants with moderate to severe encephalopathy who were between 6 and 24 hours of age to 72 hours of hypothermia or standard care. Most infants had moderate encephalopathy (90%) and clinical seizures (71%) and were enrolled after 12 hours of life (68%). The primary outcome, death or moderate-to-severe disability at 18 to 22 months of age, did not …

Reviewing Author

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Therapeutic Hypothermia: When Is It Too Late to Begin?

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Reviewing Author