Comparative Assessment Hypothermia Complication in Two Cooling Methods of Total and Head Cooling in Neonates with Asphyxia, Tabriz, 2011.

Abstract

Abstract: Introduction: Hypothermia is the most promising therapy care in infants with birth asphyxia. However, during cooling period brain temperature fluctuation will leads to cerebral edema and subsequently adverse effects on hemodynamic status and brain development. Therefore, this study conducted aim to determine side effects of hypothermia during cooling period in newborns with perinatal asphyxia. Methods: This is observational –comparative study in which 50 infants with birth asphyxia were selected using accidental method from a teaching hospital affiliated with Tabriz University of Medical Sciences. These babies underwent head cooling up to target rectal of 34-350c temperature and total body cooling up to target rectal of 32.5-33.50c temperature. They remained in this temperature for 72 hours and then it was gradually increased during 8-12 h to 36.50c. During the cooling period possible short term side effects were observed and mortality was assessed. Data was analyzed using SPSS17 and descriptive (mean, standard deviation, number, percent) and repeated ANOVA statistics. Results: According to findings, the mean time to start cooling newborns in head cooling proper was 5±1.6 hours after delivery and total body cooling was 4.5±1.8 hours after delivery while temperature fluctuation in head cooling was about 0.370c in total body cooling was about 0.410c. Meanwhile in head cooling seizure (n=19, 76%) and pulmonary hemorrhage (n=2, 8%) and total body cooling seizure (n=21, 84%) and pulmonary hemorrhage (n=3, 12%) were respectively the most and the least common short time side effects. Hypothermia related complications did not differ significantly between the two groups (p<0.05). Conclusion: Findings showed reduction in both frequency of incidence of side effects and newborns' mortality during the intervention. The hypothermia can be one of the most effective therapeutic approaches to increase survival rate and quality of life of infants with birth asphyxia.