{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:09:09Z","timestamp":1790809749446,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012317","name":"UCLH Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Therapeutic hypothermia (HT) to 33.0\u201334.0\u00b0C for 72\u00a0h provides optimal therapy for infants with neonatal encephalopathy (NE) in high\u2010resource settings. HT is not universally implemented in low\u2010 and middle\u2010income countries as a result of both limited resources and evidence.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Facilitated passive cooling, comprising infants being allowed to passively lower their body temperature in the days after birth, is an emerging practice in some West African neonatal units.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>In this observational study, we demonstrate that infants undergoing facilitated passive cooling in a neonatal unit in Accra, Ghana, achieve temperatures within the HT target range \u223c20% of the 72 h. Depth of HT fluctuates and can be excessive, as well as not maintained, especially after 24\u00a0h.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Sustained and deeper passive cooling was evident for severe NE and for those that died.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>It is important to prevent excessive cooling, to understand that severe NE babies cool more and to be aware of facilitated passive cooling with respect to the design of clinical trials in low\u2010 and mid\u2010resource settings.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Neonatal encephalopathy (NE) is a significant worldwide problem with the greatest burden in sub\u2010Saharan Africa. Therapeutic hypothermia (HT), comprising the standard of care for infants with moderate\u2010to\u2010severe NE in settings with sophisticated intensive care, is not available to infants in many sub\u2010Saharan African countries, including Ghana. We prospectively assessed the temperature response in relation to outcome in the 80\u00a0h after birth in a cohort of babies with NE undergoing \u2018facilitated passive cooling\u2019 at Korle Bu Teaching Hospital, Accra, Ghana. We hypothesized that NE infants demonstrate passive cooling. Thirteen infants (69% male) \u226536\u00a0weeks with moderate\u2010to\u2010severe NE were enrolled. Ambient mean\u00a0\u00b1\u00a0SD temperature was 28.3\u00a0\u00b1\u00a00.7\u00b0C. Infant core temperature was 34.2\u00a0\u00b1\u00a01.2\u00b0C over the first 24\u00a0h and 35.0\u00a0\u00b1\u00a01.0\u00b0C over 80\u00a0h. Nadir mean temperature occurred at 15\u00a0h. Temperatures were within target range for HT with respect to 18\u00a0\u00b1\u00a014% of measurements within the first 72\u00a0h. Axillary temperature was 0.5\u00a0\u00b1\u00a00.2\u00b0C below core. Three infants died before discharge. Core temperature over 80\u00a0h for surviving infants was 35.3\u00a0\u00b1\u00a00.9\u00b0C and 33.96\u00a0\u00b1\u00a00.7\u00b0C for those that died (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.043). Temperature profile negatively correlated with Thompson NE score on day 4 (<jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.66): infants with a Thompson score of 0\u20136 had higher temperatures than those with a score of 7\u201315 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.021) and a score of 16+\/deceased (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.007). More severe NE was associated with lower core temperatures. Passive cooling is a physiological response after hypoxia\u2013ischaemia; however, the potential neuroprotective effect of facilitated passive cooling is unknown. An awareness of facilitated passive cooling in babies with NE is important for the design of clinical trials of neuroprotection in low and mid resource settings.<\/jats:p><\/jats:sec>","DOI":"10.1113\/jp277820","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:53:55Z","timestamp":1559782435000},"page":"4013-4024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Core temperature after birth in babies with neonatal encephalopathy in a sub\u2010Saharan African hospital setting"],"prefix":"10.1113","volume":"597","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9346-5365","authenticated-orcid":false,"given":"Christabel","family":"Enweronu\u2010Laryea","sequence":"first","affiliation":[{"name":"Department of Child Health University of Ghana School of Medicine and Dentistry  Accra Ghana"},{"name":"Neonatal Intensive Care Unit Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7490-7313","authenticated-orcid":false,"given":"Kathryn A","family":"Martinello","sequence":"additional","affiliation":[{"name":"Institute for Women's Health University College London  London UK"},{"name":"Robinson Research Institute University of Adelaide  Adelaide Australia"},{"name":"Neonatology University College London Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Rose","sequence":"additional","affiliation":[{"name":"Neonatology University College London Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Manu","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-4952","authenticated-orcid":false,"given":"Cally J","family":"Tann","sequence":"additional","affiliation":[{"name":"Neonatology University College London Hospital NHS Foundation Trust  London UK"},{"name":"Maternal, Adolescent, Reproductive and Child Health Centre, Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-4577","authenticated-orcid":false,"given":"Judith","family":"Meek","sequence":"additional","affiliation":[{"name":"Neonatology University College London Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kojo","family":"Ahor\u2010Essel","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Korle Bu Teaching Hospital  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine B","family":"Boylan","sequence":"additional","affiliation":[{"name":"INFANT Research Centre University College Cork  Cork Ireland"},{"name":"Department of Paediatrics &amp; Child Health University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5783-0828","authenticated-orcid":false,"given":"Nicola J","family":"Robertson","sequence":"additional","affiliation":[{"name":"Institute for Women's Health University College London  London UK"},{"name":"Division of Neonatology Sidra Medicine  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3330K"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1700910126"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007330"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038504"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7172.1549"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2007.11.002"},{"key":"e_1_2_5_8_1","first-page":"SC16","article-title":"To study the correlation of thompson scoring in predicting early neonatal outcome in post asphyxiated term neonates","volume":"10","author":"Bhagwani DK","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5106.1197"},{"key":"e_1_2_5_10_1","first-page":"62","article-title":"MRI (2) abnormalities in anapyrexic human neonates following therapeutic hypothermia for hypoxic ischaemic encephlopathy. 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