Therapeutic hypothermia success for hypoxic-ischaemic encephalopathy in Latin America: Eight-year experience in EpicLatino Neonatal Network.

Abstract

Aim: A study reported that therapeutic hypothermia (TH) did not reduce the combined prognosis of mortality and disability at 18 months, in low- and middle-income countries for patients with hypoxic ischaemic encephalopathy (HIE) who received TH, suggesting its no implementation in these regions. We described characteristics, mortality, and neurological response before and after the use of TH in newborns with HIE within the EpicLatino Neonatal Network (ENN) and described the population of infants with HIE treated and not treated with TH.

Methods: Data were collected from 2015 to 2022 for patients with HIE. Mortality rates and Sarnat scores were compared before and after TH. The Wilcoxon Signed-Rank Test was used for comparisons.

Results: In this observational study 518 neonates of our total population of 26 970, had HIE (1.92%) of whom 150 underwent TH. Ten out of 21 neonatal intensive care units (NICUs) provided TH. The Wilcoxon Signed Rank Test for 138 cases with complete data showed a significant difference.

Conclusion: The findings support the benefits of TH in HIE within this cohort. TH should not be withheld solely due to the economic status of the country. A strict patient selection and TH protocol are essential.