Evidence map›Paper›PMID 23527034›Full record

SynthesisPloS one2013

Therapeutic hypothermia for neonatal encephalopathy in low- and middle-income countries: a systematic review and meta-analysis.

Shreela S Pauliah, Seetha Shankaran, Angie Wade, Ernest B Cady, Sudhin Thayyil

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03786497 (Protecting Brains and Saving Futures - the PBSF Protocol), which is not on this map. Cited by 71 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 10 pooled it
14.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03786497 unknown statusnot on this mapstarted 2021, after this paper: background citation

Protecting Brains and Saving Futures - the PBSF Protocol: a Prospective Multicenter and Observational Study on the Use of Telemedicine for Neurocritical Care in High-risk Newborns in Brazil.

Typeobservational_patient_registrySponsorProtecting Brains Saving FuturesRan2021 to 2023Enrolled2,268ConditionsBrain Injuries, Congenital Heart Disease, Newborn Morbidity, Intraventricular Hemorrhage
3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 10 syntheses or guidelines pooled it, 169 citations in OpenAlex.

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  10. Neonatal Encephalopathy With Group B Streptococcal Disease Worldwide: Systematic Review, Investigator Group Datasets, and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017
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  17. Umbilical cord milking for neonates who are depressed at birth: a randomized trial of feasibility.Journal of perinatology : official journal of the California Perinatal Association · 2018
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11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Shreela S PauliahAcademic Neonatology, Institute for Women's Health, University College London, London, United Kingdom.
Seetha Shankaran
Angie Wade
Ernest B Cady
Sudhin Thayyil
University College London · GBUniversity College Hospital · GBWayne State University · US

Funding

Department of Health NIHR/CS/010/022
6 · The paper itself

Abstract

unlabelledAlthough selective or whole body cooling combined with optimal intensive care improves outcomes following neonatal encephalopathy in high-income countries, the safety and efficacy of cooling in low-and middle-income countries is not known.

objectiveWe performed a systematic review and meta-analysis of all published randomised or quasi-randomised controlled trials of cooling therapy for neonatal encephalopathy in low-and middle-income countries.

resultsSeven trials, comprising a total of 567 infants were included in the meta-analysis. Most study infants had mild (15%) or moderate encephalopathy (48%) and did not receive invasive ventilation (88%). Cooling devices included water-circulating cooling caps, frozen gel packs, ice, water bottles, and phase-changing material. No statistically significant reduction in neonatal mortality was seen with cooling (risk ratio: 0.74, 95% confidence intervals: 0.44 to 1.25). Data on other neonatal morbidities and long-term neurological outcomes were insufficient.

conclusionCooling therapy was not associated with a statistically significant reduction in neonatal mortality in low-and middle-income countries although the confidence intervals were wide and not incompatible with results seen in high-income countries. The apparent lack of treatment effect may be due to the heterogeneity and poor quality of the included studies, inefficiency of the low technology cooling devices, lack of optimal neonatal intensive care, sedation and ventilatory support, overuse of oxygen, or may be due to the intrinsic difference in the population, for example higher rates of perinatal infection, obstructed labor, intrauterine growth retardation and maternal malnutrition. Evaluation of the safety and efficacy of cooling in adequately powered randomised controlled trials is required before cooling is offered in routine clinical practice in low-and middle-income countries.

Indexed as

Developing CountriesHypothermia, InducedBrain DiseasesHumansInfant, NewbornPublication BiasSepsisTreatment Outcome

Identifiers

PMID23527034
PMCPMC3602578
OpenAlexW1965626286

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.