ArticleEuropean journal of pediatrics2025
Therapeutic hypothermia in preterm infants under 36 weeks: Case series on outcomes and brain MRI findings.
Article in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Therapeutic hypothermia in infants <36 weeks gestation: proceed with caution.Pediatric research · 2026Article
- Evidence versus equipoise in late preterm neonates with encephalopathy; to cool or not to cool, that is the question!Pediatric research · 2026Article
- Case Report: RYR1-related myopathy with hypoxic ischemic encephalopathy-a case of severe neonatal presentation due to aFrontiers in pediatrics · 2026Article
- The shifting landscape of the preterm brain.Neuron · 2025Review
- Therapeutic hypothermia for neonates: a bibliometric analysis and visualization research.Frontiers in neurology · 2025Article
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4 authors.
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Abstract
purposePerinatal hypoxic-ischemic encephalopathy (HIE) is a significant cause of neonatal brain injury. Therapeutic hypothermia (TH) is the standard treatment for term neonates, but its safety and efficacy in neonates < 36 weeks gestational age (GA) remains unclear. This case series aimed to evaluate the outcomes of preterm infants with HIE treated with TH.
methodsRetrospective analysis of preterm infants (< 36w GA) treated with TH (01/2019-06/2024). Data on demographics, clinical complications, coagulation profiles, brain magnetic resonance imaging (MRI), and neurodevelopment outcomes were analyzed.
resultsSeventeen patients were included (range 32.5-35.5w, median 34.4; birthweight range 1556-2493 g, median 2300 g), 58.8% were male. Placental abruption was identified in 7 cases (41.2%), and 8 (47.1%) required advanced resuscitation. Thirteen patients (76.5%) presented anemia, 12 (70.6%) coagulopathy, 9 (52.9%) thrombocytopenia, and 9 (52.9%) acute liver failure. Hypofibrinogenemia (< 1 g/L) was significantly associated with severe intracranial hemorrhage (ICH), defined as extracerebral, intraventricular or parenchymal hemorrhage causing mass effect. MRI findings were classified based on the predominant lesion: I- hypoxic-ischemic injury, II- severe ICH, or III- normal/mild findings. Severe ICH was the predominant lesion in 4 cases (23.5%). White matter injury was seen in 12 (76%). Death occurred in 8 cases (47.1%). Of the 9 surviving patients, at 2 years, 6 (66.7%) had normal neurodevelopment, while 1 (11.1%) had severe disability.
conclusionCoagulation abnormalities, particularly hypofibrinogenemia, significantly increase the risk of severe ICH in < 36w infants treated with TH. The safety and efficacy of TH in this population require further investigation.
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