ArticleEClinicalMedicine2021
Morphine and fentanyl exposure during therapeutic hypothermia does not impair neurodevelopment.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 32 citations in OpenAlex.
- Whole-Body Hypothermia vs Targeted Normothermia for Neonates With Mild Encephalopathy: A Multicenter Pilot Randomized Clinical Trial.JAMA network open · 2024Trial
- The effect of using dexmedetomidine versus morphine as sedation on long-term neurodevelopmental outcomes of encephalopathic neonates undergoing therapeutic hypothermia.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Estimated equipotent conversion ratios of morphine, sufentanil and fentanyl as continuous infusion in neonatal intensive care units: a pharmacoepidemiologic cohort study.European journal of clinical pharmacology · 2025Observational
- Sedation and Pain Management in Neonates Undergoing Therapeutic Hypothermia for Hypoxic-Ischemic Encephalopathy.Children (Basel, Switzerland) · 2025Review
- Oral Clonidine-Based Strategy to Reduce Opiate Use During Cooling for Neonatal Encephalopathy: An Observational Study.The Journal of pediatrics · 2024Observational
- Whole-body hypothermia in mild neonatal encephalopathy: protocol for a multicentre phase III randomised controlled trial.BMC pediatrics · 2024Article
- The effects of anaesthesia on cell death in a porcine model of neonatal hypoxic-ischaemic brain injury.BJA open · 2024Article
- Short-term effects of opioids during therapeutic hypothermia for neonatal encephalopathy.Frontiers in pediatrics · 2024Article
- Safety and efficacy of therapeutic hypothermia in neonates with mild hypoxic-ischemic encephalopathy.BMC pediatrics · 2023Article
- Article
- Analgesia and sedation strategies in neonates undergoing whole-body therapeutic hypothermia: A scoping review.PloS one · 2023Article
- Adequacy of sedation analgesia to support the comfort of neonates undergoing therapeutic hypothermia and its impact on short-term neonatal outcomes.Frontiers in pediatrics · 2023Article
- Unique Pharmacology, Brain Dysfunction, and Therapeutic Advancements for Fentanyl Misuse and Abuse.Neuroscience bulletin · 2022Review
- Physiological responses to cuddling babies with hypoxic-ischaemic encephalopathy during therapeutic hypothermia: an observational study.BMJ paediatrics open · 2021Observational
- Fluid Supply and Feeding Practices in Cooled Asphyxiated Newborns.Children (Basel, Switzerland) · 2021Article
- MRI combined with early clinical variables are excellent outcome predictors for newborn infants undergoing therapeutic hypothermia after perinatal asphyxia.EClinicalMedicine · 2021Article
- Neural Function Recovery and Safety of Mild Hypothermia Therapy Combined with Monosialotetrahexosylganglioside on Neonatal Asphyxia Complicated by Hypoxic Ischemic Encephalopathy.Computational and mathematical methods in medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypothermia-treated and intubated infants with moderate or severe hypoxic-ischemic encephalopathy (HIE) usually receive morphine for sedation and analgesia (SA) during therapeutic hypothermia (TH) and endotracheal ventilation. Altered drug pharmacokinetics in this population increases the risk of drug accumulation. Opioids are neurotoxic in preterm infants. In term infants undergoing TH, the long-term effects of morphine exposure are unknown. We examined the effect of opioid administration during TH on neurodevelopmental outcome and time to extubation after sedation ended.
methodsIn this prospectively collected population-based cohort of 282 infants with HIE treated with TH (2007-2017), the cumulative opioid dose of morphine and equipotent fentanyl (10-60 µg/kg/h) administered during the first week of life was calculated. Clinical outcomes and concomitant medications were also collected. Of 258 survivors, 229 underwent Bayley-3 neurodevelopmental assessments of cognition, language and motor function at 18-24 months. Multivariate stepwise linear regression analysis was used to examine the relation between cumulative opioid dose and Bayley-3 scores. Three severity-groups (mild-moderate-severe) were stratified by early (<6 h) amplitude-integrated electroencephalography (aEEG) patterns.
findingsThe cumulative dose of opioid administered as SA during TH was median (IQR) 2121 µg/kg (1343, 2741). Time to extubation was independent of SA dose (
interpretationHigher cumulative opioid doses in TH-treated infants with HIE was not associated with worse Bayley-3 scores at 18-24 months of age.
fundingThe Bristol cooling program was funded by the Children's Medical Research Charity SPARKS managing donations for our research from the UK and US, the UK Moulton Foundation, the Lærdal Foundation for Acute Medicine in Norway and the Norwegian Research Council (JKG).
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Registered trials
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