Therapeutic Hypothermia: More Is Not Better

Therapeutic hypothermia reduces the risk for neurodevelopmental impairment for term and near-term infants with hypoxic-ischemic encephalopathy and has become standard therapy for this condition. Preclinical trials suggest that cooling therapy could be further optimized by extending its duration or lowering the temperature further.

In the current trial, investigators randomized 364 term infants with moderate or severe hypoxic ischemic encephalopathy to receive standard hypothermia (33.5^oC for 72 hours), deeper hypothermia (32.0^oC for 72 hours), longer hypothermia (33.5^oC for 120 hours), or both (32.0^oC for 120 hours). The trial was stopped before its planned recruitment goal of 726 infants because of trends toward increased hospital mortality…