• Mohamed A Tagin, Christy G Woolcott, Michael J Vincer, Robin K Whyte, and Dora A Stinson.
• Department of Paediatrics,The Hospital for Sick Children,University of Toronto, Toronto, Ontario, Canada. mohamed.tagin@utoronto.ca
• Arch Pediatr Adolesc Med. 2012 Jun 1;166(6):558-66.

ObjectiveTo establish the evidence of therapeutic hypothermia for newborns with hypoxic ischemic encephalopathy(HIE).Data SourcesCochrane Central Register of Controlled Trials, Oxford Database of Perinatal Trials, MEDLINE, EMBASE, and previous reviews.Study SelectionRandomized controlled trials that compared therapeutic hypothermia to normothermia for newborns with HIE.InterventionTherapeutic hypothermia.Main Outcome MeasuresDeath or major neurodevelopmental disability at 18 months.ResultsSeven trials including 1214 newborns were identified. Therapeutic hypothermia resulted in a reduction in the risk of death or major neurodevelopmental disability(risk ratio [RR], 0.76; 95% CI, 0.69-0.84) and increase in the rate of survival with normal neurological function (1.63; 1.36-1.95) at age 18 months. Hypothermia reduced the risk of death or major neurodevelopmental disability at age 18 months in newborns with moderate HIE (RR, 0.67; 95% CI, 0.56-0.81) and in newborns with severe HIE (0.83; 0.74-0.92). Both total body cooling and selective head cooling resulted in reduction in the risk of death or major neurodevelopmental disability(RR, 0.75; 95% CI, 0.66-0.85 and 0.77; 0.65-0.93,respectively).ConclusionHypothermia improves survival and neurodevelopment in newborns with moderate to severe HIE.Total body cooling and selective head cooling are effective methods in treating newborns with HIE. Clinicians should consider offering therapeutic hypothermia as part of routine clinical care to these newborns.

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