{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T05:41:43Z","timestamp":1772084503357,"version":"3.50.1"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,3,1]]},"abstract":"<jats:sec><jats:title>Objectives.<\/jats:title><jats:p>To determine the neurodevelopmental outcome of infants treated with head cooling with systemic hypothermia after hypoxic-ischemic encephalopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Group.<\/jats:title><jats:p>Infants \u226537 weeks' gestation, who had an umbilical artery pH \u22647.09 or Apgar score \u22646 at 5 minutes, plus clinical encephalopathy. Infants with major congenital abnormalities were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Design.<\/jats:title><jats:p>Infants were allocated to either no cooling (rectal temperature = 37.0 \u00b1 0.2\u00b0C, n= 15), or, sequentially, to head cooling accompanied by different levels of systemic hypothermia, including minimal cooling, rectal temperature 36.5\u00b0C to 36\u00b0C (n = 6), and mild cooling, to either 35.9\u00b0C to 35.5\u00b0C (n = 6), 35 \u00b1 0.5\u00b0C (n = 6) or 34.5 \u00b1 0.5\u00b0C (n = 7). Head cooling was accomplished by circulating cooled water through a coil of tubing wrapped around the head for up to 72 hours. Survivors were followed up with regular neurologic examination by a neonatologist until 18 months of age, then with blinded developmental testing using the revised Bayley Scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>A total of 40 term infants were enrolled from 2 to 5 hours after birth. The control and the cooled groups were not significantly different for gestation, birth weight, Apgar score, and initial pH. There were 6 early neonatal deaths (3 normothermic and 3 cooled), and 1 death in infancy associated with severe spastic cerebral palsy in a normothermic infant. Six normothermic, 1 minimally cooled, and 4 mildly cooled infants had early stage 1 encephalopathy; all but 1 had a good outcome. Among infants with early stage 2 or 3 encephalopathy, an adverse outcome was found in 4 of 9 normothermic infants (44%) and 4 of 5 minimally cooled infants (80%), whereas in the combined mildly cooled groups, an adverse outcome was found in 4 of 15 infants (26%, odds ratio 0.46 [0.08, 2.56] vs normothermia).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>The present study supports the safety of hypothermia, with no evidence of late adverse effects in any infant. Among infants with moderate to severe encephalopathy at enrollment, there was a tendency toward better outcome. These results emphasize the relatively wide range of outcomes using purely clinical criteria for enrollment. Therapeutic hypothermia should not be used outside of stringent, multicenter trials.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.107.3.480","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"480-484","source":"Crossref","is-referenced-by-count":144,"title":["Neurodevelopmental Outcome of Infants Treated With Head Cooling and Mild Hypothermia After Perinatal Asphyxia"],"prefix":"10.1542","volume":"107","author":[{"given":"Malcolm R.","family":"Battin","sequence":"first","affiliation":[{"name":"From the Newborn Service, National Women's Hospital, Auckland, New Zealand; and the"},{"name":"Department of Paediatrics and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Anne","family":"Dezoete","sequence":"additional","affiliation":[{"name":"From the Newborn Service, National Women's Hospital, Auckland, New Zealand; and the"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania R.","family":"Gunn","sequence":"additional","affiliation":[{"name":"From the Newborn Service, National Women's Hospital, Auckland, New Zealand; and the"},{"name":"Department of Paediatrics and"},{"name":"Research Centre for Developmental Medicine and Biology, University of Auckland, Auckland, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D.","family":"Gluckman","sequence":"additional","affiliation":[{"name":"Research Centre for Developmental Medicine and Biology, University of Auckland, Auckland, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alistair J.","family":"Gunn","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and"},{"name":"Research Centre for Developmental Medicine and Biology, University of Auckland, Auckland, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2001,3,1]]},"reference":[{"key":"2021121009362872200_B1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/00008480-200004000-00004","article-title":"Cerebral hypothermia for prevention of brain injury following perinatal asphyxia.","volume":"12","author":"Gunn","year":"2000","journal-title":"Curr Opin Pediatr"},{"key":"2021121009362872200_B2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1111\/j.1469-8749.1997.tb07372.x","article-title":"Relation of deranged neonatal cerebral oxidative metabolism with neurodevelopmental outcome and head circumference at 4 years.","volume":"39","author":"Roth","year":"1997","journal-title":"Dev Med Child Neurol"},{"key":"2021121009362872200_B3","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1203\/00006450-199412000-00003","article-title":"Delayed (\u201csecondary\u201d) cerebral energy failure after acute hypoxia-ischemia in the newborn piglet: continuous 48-hour studies by phosphorus magnetic resonance spectroscopy.","volume":"36","author":"Lorek","year":"1994","journal-title":"Pediatr Res"},{"key":"2021121009362872200_B4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1479-828X.1997.tb02214.x","article-title":"Changes in risk factors for hypoxic-ischaemic seizures in term infants.","volume":"37","author":"Gunn","year":"1997","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2021121009362872200_B5","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1542\/peds.102.4.885","article-title":"Selective head cooling in newborn infants after perinatal asphyxia: a safety study.","volume":"102","author":"Gunn","year":"1998","journal-title":"Pediatrics"},{"key":"2021121009362872200_B6","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s001340051020","article-title":"Induced brain hypothermia in asphyxiated human newborn infants: a retrospective chart analysis of physiological and adverse effects.","volume":"25","author":"Simbruner","year":"1999","journal-title":"Intensive Care Med"},{"key":"2021121009362872200_B7","first-page":"P18","article-title":"Head cooling with mild systemic hypothermia following birth asphyxia: a safety study.","volume":"3","author":"Gunn","year":"1999","journal-title":"Proc Annu Congress Perinat Soc Aust N Z"},{"key":"2021121009362872200_B8"},{"key":"2021121009362872200_B9","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1542\/peds.106.1.92","article-title":"Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants with hypoxic-ischaemic encephalopathy.","volume":"106","author":"Thoresen","year":"2000","journal-title":"Pediatrics"},{"key":"2021121009362872200_B10","first-page":"868","article-title":"Neonatal asphyxia pallida treated with hypothermia alone or with hypothermia and transfusion of oxygenated blood.","volume":"45","author":"Westin","year":"1959","journal-title":"Surgery"},{"key":"2021121009362872200_B11","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1159\/000239893","article-title":"Hypothermia in the treatment of asphyxia neonatorum.","volume":"6","author":"Miller","year":"1964","journal-title":"Biol Neonate"},{"key":"2021121009362872200_B12","first-page":"760","article-title":"Hypothermia in resuscitating newborns in white asphyxia. 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