{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T23:16:51Z","timestamp":1783552611748,"version":"3.55.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"10","funder":[{"name":"Becton, Dickinson and Company, New Jersey, United States"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to compare temperature control during therapeutic hypothermia (TH) in neonates with moderate or severe hypoxic\u2013ischemic encephalopathy (HIE) using manual cooling (MC) or a servo-controlled (SC) system.<\/jats:p>\n                  <jats:p>Retrospective cohort study including neonates with \u2265 35 weeks' gestation with moderate or severe HIE who were treated with TH between 2018 and 2020, using MC with ice packs or a SC system. Temperature curves and clinical outcomes were compared between the two methods of cooling. Data were summarized using descriptive statistics. Groups were compared with appropriate parametric or nonparametric tests. Temperature stability and rewarming variability were evaluated, and secondary outcomes were analyzed using risk ratios with 95% confidence intervals and logistic regression adjusted for encephalopathy severity.<\/jats:p>\n                  <jats:p>During the study period, 56 neonates with moderate or severe HIE were cooled, 31 (55.4%) with MC and 25 (44.6%) with a SC system. Baseline characteristics and time to target temperature were similar. SC achieved more stable hypothermia, with less variability (p\u2009=\u20090.014) and reduced time outside the therapeutic range (2.7 vs. 8.1%, p\u2009=\u20090.005). Extreme temperature deviations occurred only in the MC group. Rewarming rates were comparable, although variability was greater with MC. Clinical outcomes showed lower risk of hypotension (RR: 0.647, 95% CI: 0.409\u20131.02; p\u2009=\u20090.044), inotrope use (RR: 0.647, 95% CI: 0.409\u20131.02; p\u2009=\u20090.044), and abnormal magnetic resonance imaging (MRI) findings (12.0 vs. 46.2%; RR: 0.26, 95% CI: 0.08\u20130.81; p\u2009=\u20090.013) in the SC group. After adjusting for clinical encephalopathy severity, SC remained independently protective against abnormal MRI (aOR: 0.19; 95% CI: 0.04\u20130.865; p\u2009=\u20090.03) and hypotension (aOR: 0.27; 95% CI: 0.08\u20130.95; p\u2009=\u20090.04). Mortality occurred only in the MC group.<\/jats:p>\n                  <jats:p>While both methods were effective, the SC system offered more stable temperature control and may reduce complications during and after TH.<\/jats:p>","DOI":"10.1055\/a-2752-8853","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T23:56:43Z","timestamp":1764979003000},"page":"1315-1321","source":"Crossref","is-referenced-by-count":0,"title":["Servo-Controlled versus Manual Cooling for Therapeutic Hypothermia in Neonatal Hypoxic\u2013Ischemic Encephalopathy: A Retrospective Comparative Study"],"prefix":"10.1055","volume":"43","author":[{"given":"Maur\u00edcio","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Irmandade da Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Protecting Brains & Saving Futures, Clinical Research Department, S\u00e3o Paulo, Brazil"},{"name":"Santa Casa de S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danieli M. K.","family":"Leandro","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Irmandade da Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Protecting Brains & Saving Futures, Clinical Research Department, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia S.","family":"de Azevedo","sequence":"additional","affiliation":[{"name":"Protecting Brains & Saving Futures, Clinical Research Department, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Q.","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Protecting Brains & Saving Futures, Clinical Research Department, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah A.","family":"Hiratzuka","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Irmandade da Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo J.","family":"Mimica","sequence":"additional","affiliation":[{"name":"Protecting Brains & Saving Futures, Clinical Research Department, S\u00e3o Paulo, Brazil"},{"name":"Santa Casa de S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel F. T.","family":"Variane","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Irmandade da Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Protecting Brains & Saving Futures, Clinical Research Department, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"100223","DOI":"10.1016\/j.gpeds.2024.100223","article-title":"Neuroprotective treatment options for neonatal hypoxic-ischemic encephalopathy: therapeutic hypothermia and beyond","volume":"9","author":"M Cetinkaya","year":"2024","journal-title":"Glob Pediatr"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"101262","DOI":"10.1016\/j.siny.2021.101262","article-title":"Optimizing initial neonatal resuscitation to reduce neonatal encephalopathy around the 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