Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy
Background/Objectives: Hypoxic–ischemic encephalopathy (HIE), affecting 1.3–1.7/1000 live births, is treated with conventional therapeutic hypothermia (TH) but carries significant mortality and neurological impairment. Here, we compared intravascular cooling with extracorporeal membrane oxygenation...
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MDPI AG
2025-05-01
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| Series: | Children |
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| author | Tomonori Kurimoto Takuya Tokuhisa Itaru Hayasaka Tsuyoshi Yamamoto Eiji Hirakawa Hiroshi Ohashi Masaya Kibe Asataro Yara Takatsugu Maeda Masato Kamitomo Satoshi Ibara |
| author_facet | Tomonori Kurimoto Takuya Tokuhisa Itaru Hayasaka Tsuyoshi Yamamoto Eiji Hirakawa Hiroshi Ohashi Masaya Kibe Asataro Yara Takatsugu Maeda Masato Kamitomo Satoshi Ibara |
| author_sort | Tomonori Kurimoto |
| collection | DOAJ |
| description | Background/Objectives: Hypoxic–ischemic encephalopathy (HIE), affecting 1.3–1.7/1000 live births, is treated with conventional therapeutic hypothermia (TH) but carries significant mortality and neurological impairment. Here, we compared intravascular cooling with extracorporeal membrane oxygenation (ECMO) and conventional TH in neonates with moderate to severe HIE. Methods: We retrospectively analyzed single-center neonates born in 2000–2022. Neonates with a 10 min Apgar score ≤ 3 or umbilical artery pH ≤ 6.7, along with persistent pulmonary hypertension of the newborn and an oxygenation index of ≥25 to <40, were divided into ECMO (<i>n</i> = 17) and conventional TH (<i>n</i> = 18) groups and administered the Kyoto Scale of Psychological Development at 18 months. Results: Neonatal and maternal characteristics were similar between the groups. A significantly higher proportion of the ECMO group (70.6% vs. 33.3%) achieved a developmental quotient ≥ 70. Conclusions: Intravascular cooling with ECMO may improve the neurodevelopmental outcomes of neonates with HIE, severe acidosis, and low Apgar scores. |
| format | Article |
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| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-1e15d0021ce1442e8f6970f103926da22025-08-20T03:47:49ZengMDPI AGChildren2227-90672025-05-0112560510.3390/children12050605Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic EncephalopathyTomonori Kurimoto0Takuya Tokuhisa1Itaru Hayasaka2Tsuyoshi Yamamoto3Eiji Hirakawa4Hiroshi Ohashi5Masaya Kibe6Asataro Yara7Takatsugu Maeda8Masato Kamitomo9Satoshi Ibara10Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Obstetrics and Gynecology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Obstetrics and Gynecology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanDepartment of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima 890-8760, JapanBackground/Objectives: Hypoxic–ischemic encephalopathy (HIE), affecting 1.3–1.7/1000 live births, is treated with conventional therapeutic hypothermia (TH) but carries significant mortality and neurological impairment. Here, we compared intravascular cooling with extracorporeal membrane oxygenation (ECMO) and conventional TH in neonates with moderate to severe HIE. Methods: We retrospectively analyzed single-center neonates born in 2000–2022. Neonates with a 10 min Apgar score ≤ 3 or umbilical artery pH ≤ 6.7, along with persistent pulmonary hypertension of the newborn and an oxygenation index of ≥25 to <40, were divided into ECMO (<i>n</i> = 17) and conventional TH (<i>n</i> = 18) groups and administered the Kyoto Scale of Psychological Development at 18 months. Results: Neonatal and maternal characteristics were similar between the groups. A significantly higher proportion of the ECMO group (70.6% vs. 33.3%) achieved a developmental quotient ≥ 70. Conclusions: Intravascular cooling with ECMO may improve the neurodevelopmental outcomes of neonates with HIE, severe acidosis, and low Apgar scores.https://www.mdpi.com/2227-9067/12/5/605hypoxic–ischemic encephalopathytherapeutic hypothermiaintravascular coolingextracorporeal membrane oxygenationneurodevelopmentApgar score |
| spellingShingle | Tomonori Kurimoto Takuya Tokuhisa Itaru Hayasaka Tsuyoshi Yamamoto Eiji Hirakawa Hiroshi Ohashi Masaya Kibe Asataro Yara Takatsugu Maeda Masato Kamitomo Satoshi Ibara Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy Children hypoxic–ischemic encephalopathy therapeutic hypothermia intravascular cooling extracorporeal membrane oxygenation neurodevelopment Apgar score |
| title | Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy |
| title_full | Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy |
| title_fullStr | Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy |
| title_full_unstemmed | Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy |
| title_short | Efficacy of Intravascular Therapeutic Hypothermia for Moderate to Severe Hypoxic–Ischemic Encephalopathy |
| title_sort | efficacy of intravascular therapeutic hypothermia for moderate to severe hypoxic ischemic encephalopathy |
| topic | hypoxic–ischemic encephalopathy therapeutic hypothermia intravascular cooling extracorporeal membrane oxygenation neurodevelopment Apgar score |
| url | https://www.mdpi.com/2227-9067/12/5/605 |
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