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Cooling in mild HIE

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Do anyone practice to start cooling in babies not fulfill all criteria for Therapeutic hypothermia?? What's the benefits and what is the harm?? There is any new recommendations to start cooling in mild HIE??


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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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