{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:18:34Z","timestamp":1773285514703,"version":"3.50.1"},"reference-count":15,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Bronchiolitis is a clinical syndrome involving the lower respiratory tract of infants and young children. The majority of patients recover using adequate hydration and oxygen (O2) therapy, while a small number of patients require ventilatory assistance. Beyond these therapeutical approaches, there are no available strategies for patients that do not improve. Hypothermia is a measure used to prevent neonatal hypoxic\u2013ischemic encephalopathy by preventing carbon dioxide (CO2) production and subsequent tissue damage. Other medical applications of hypothermia have been proposed, such as in acute respiratory failure and necrotizing colitis. Case report: We report the case of a 50-day-old girl hospitalized with severe bronchiolitis caused by respiratory syncytial virus. On admission, the girl presented severe hypercapnic respiratory failure, requiring intubation and ventilatory support with conventional and non-conventional systems. However, the patient\u2019s general conditions worsened with elevated O2 demand, thus whole-body hypothermia was attempted and performed for 48 h, with a gradual improvement in the respiratory function. No adverse effects were detected. Conclusions: Whole-body hypothermia could have a critical role as a rescue treatment in infants affected by severe hypercapnic respiratory failure, at the expense of few and rare side effects (bradycardia, coagulopathy, hyperglycemia). Notably, beyond reducing CO2 production, whole-body hypothermia might have an impact in restoring lung function in newborns using bronchiolitis refractory to maximal medical therapy and invasive ventilation.<\/jats:p>","DOI":"10.3390\/children9091339","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T21:27:17Z","timestamp":1662067637000},"page":"1339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Hypercapnia Requiring 48-h Whole-Body Hypothermia in an Infant with Acute Bronchiolitis"],"prefix":"10.3390","volume":"9","author":[{"given":"Michela","family":"Librandi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Chieti\u2014Pescara, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2605-925X","authenticated-orcid":false,"given":"Serena","family":"Scapaticci","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Chieti\u2014Pescara, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Chiavaroli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Pescara Public Hospital, 65123 Pescara, Italy"},{"name":"Liggins Institute, University of Auckland, Auckland 1010, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Altea","family":"Petrucci","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Pescara Public Hospital, 65123 Pescara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Cicioni","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Pescara Public Hospital, 65123 Pescara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Cognigni","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Pescara Public Hospital, 65123 Pescara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Chiarelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Chieti\u2014Pescara, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Di Valerio","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Pescara Public Hospital, 65123 Pescara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.12968\/hmed.2019.80.5.278","article-title":"Bronchiolitis: An update on management and prophylaxis","volume":"80","author":"Karampatsas","year":"2019","journal-title":"Br. J. Hosp. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/jcbfm.2013.165","article-title":"Cerebral oxygen metabolism in neonatal hypoxicischemic encephalopathy during and after therapeutic hypthermia","volume":"34","author":"Dehaes","year":"2014","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1007\/s00431-012-1769-6","article-title":"Rescue hypothermia for refractory hypercapnia","volume":"171","author":"Pietrini","year":"2012","journal-title":"Eur. J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.4187\/respcare.01211","article-title":"Use of hypothermia to allow low-tidal-volume ventilation in a patient with ARDS","volume":"56","author":"Duan","year":"2011","journal-title":"Respir. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/0885066617701117","article-title":"Is Therapeutic Hypothermia for Acute Respiratory Distress Syndrome the Future?","volume":"32","author":"Hayek","year":"2017","journal-title":"J. Intensiv. Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jcrc.2021.01.008","article-title":"Successful use of mild therapeutic hypothermia as compassionate treatment for severe refractory hypoxemia in COVID-19","volume":"63","author":"Cruces","year":"2021","journal-title":"J. Crit. Care"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Jacobs, S.E., Berg, M., Hunt, R., Tarnow-Mordi, W.O., Inder, T.E., and Davis, P.G. (2013). Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst. Rev., 2013.","DOI":"10.1002\/14651858.CD003311.pub3"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Autilio, C., Echaide, M., De Luca, D., and P\u00e9rez-Gil, J. (2018). Controlled hypothermia may improve surfactant function in asphyxiated neonates with or without meconium aspiration syndrome. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0192295"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.resuscitation.2009.12.007","article-title":"Body temperature effects on lung injury in ventilated preterm lambs","volume":"81","author":"Ball","year":"2010","journal-title":"Resuscitation"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Nespeca, M., Giorgetti, C., Nobile, S., Ferrini, I., Simonato, M., Verlato, G., Cogo, P., and Carnielli, V.P. (2016). Does Whole-Body Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy Affect Surfactant Disaturated-Phosphatidylcholine Kinetics?. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0153328"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/j.resuscitation.2010.09.006","article-title":"The effect of induced hypothermia on respiratory parameters in mechanically ventilated patients","volume":"81","author":"Aslami","year":"2010","journal-title":"Resuscitation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"925","DOI":"10.2174\/138945012800675641","article-title":"Neuroprotection and hypothermia in infants and children","volume":"13","author":"Pietrini","year":"2012","journal-title":"Curr. Drug Targets"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1183\/09031936.00117714","article-title":"Effect of whole-body hypothermia on inflammation and surfactant function in asphyxiated neonates","volume":"44","author":"Minucci","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/apa.12476","article-title":"Respiratory function parameters in ventilated newborn infants undergoing whole body hypothermia","volume":"103","author":"Dassios","year":"2013","journal-title":"Acta Paediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S186","DOI":"10.1097\/CCM.0b013e3181aa5241","article-title":"Mechanisms of action, physiological effects, and complications of hypothermia","volume":"37","author":"Polderman","year":"2009","journal-title":"Crit. 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