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Cooling in mild HIE


nashwa

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Our guidelines are to cool infants with HIE of grade 2-3, or if seizures develop within 6h of life.

But I know there are some discussions ongoing, check this paper out (https://www.ncbi.nlm.nih.gov/pubmed/26352683) that is also discussed in a blog post ~2 years back by Keith Barrington: https://neonatalresearch.org/2016/09/29/its-only-mild-encephalopathy-now-can-we-stop-worrying/

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I don't know anyone who intentionally sets out to cool babies with mild HIE, but I think there is a degree of therapeutic creep which means that we are probably cooling more babies now than we did a few years ago. 

The COMET feasibility study is looking at no cooling v 24 hrs cooling v 48 hrs cooling v 72 hours cooling in mild HIE. Their protocol is here: COMET 

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  • 2 weeks later...

Kindly go through the recent article from ADCFN december 2018 ( meta-analysis - hypothermia in mild encephalopathy) - The paper also mentions that almost 3/4th of UK centres treat mild HIE with cooling, but for a lesser duration of time ranging from 24-72 hours. PMID 30567775. 

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