Safety of Moderate Hypothermia for Perinatal Hypoxic Ischemic Encephalopathy: A Meta-analysis

Publication date: Available online 5 May 2017
Source:Pediatric Neurology
Author(s): Wei Zhang, Jing Ma, Quzhen Danzeng, Yue Tang, Meizhu Lu, Yan Kang
ObjectiveTo determine the safety of therapeutic hypothermia during intervention in infants with hypoxic ischemic encephalopathy (HIE).Data SourcesThe MEDLINE, EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials from onset to November 30, 2016 were searched for studies on perinatal HIE.Study SelectionRandomized controlled trials comparing the use of therapeutic hypothermia with normothermia for perinatal HIE were included in the study.Data ExtractionSafety and efficacy data for therapeutic hypothermia in 1806 infants with HIE were included in this meta-analysis. The primary outcomes were safety variables, and the secondary outcomes were efficacy variables. A fixed effect model was used to perform the meta-analysis. Risk ratios (RR), risk differences (RD), and 95% confidence intervals (CI) were calculated.Data SynthesisThirteen trials, including 1806 infants, contained information on safety and efficacy variables. Moderate hypothermia significantly increased the risk of thrombocytopenia (RR 1.18, 95% CI 1.02 to 1.37, p=0.03; RD 0.06, 95% CI −0.02 to 0.09) and cardiac arrhythmia (RR 2.52, 95% CI 1.62 to 3.93, p˂0.0001; RD 0.19, 95% CI 0.09 to 0.03) during intervention.ConclusionsIn infants with HIE, the application of therapeutic hypothermia increases the risk of thrombocytopenia and cardiac arrhythmia during intervention.



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