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Therapeutic hypothermia for mild neonatal encephalopathy: A systematic review and meta-analysis

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Title: Therapeutic hypothermia for mild neonatal encephalopathy: A systematic review and meta-analysis
Authors: Kariholu, U
Montaldo, P
Markati, T
Lally, PJ
Teiserskas, J
Liow, N
Oliveira, V
Soe, A
Shankaran, S
Thayyil, S
Item Type: Journal Article
Abstract: Objectives To examine if therapeutic hypothermia reduces the composite outcome of death, moderate or severe disability at 18 months or more after mild neonatal encephalopathy (NE). Data source MEDLINE, Cochrane database, Scopus and ISI Web of Knowledge databases, using ‘hypoxic ischaemic encephalopathy’, ‘newborn’ and ‘hypothermia’, and ‘clinical trials’ as medical subject headings and terms. Manual search of the reference lists of all eligible articles and major review articles and additional data from the corresponding authors of selected articles. Study selection Randomised and quasirandomised controlled trials comparing therapeutic hypothermia with usual care. Data extraction Safety and efficacy data extracted independently by two reviewers and analysed. Results We included the data on 117 babies with mild NE inadvertently recruited to five cooling trials (two whole-body cooling and three selective head cooling) of moderate and severe NE, in the meta-analysis. Adverse outcomes occurred in 11/56 (19.6%) of the cooled babies and 12/61 (19.7%) of the usual care babies (risk ratio 1.11 (95% CIs 0.55 to 2.25)). Conclusions Current evidence is insufficient to recommend routine therapeutic hypothermia for babies with mild encephalopathy and significant benefits or harm cannot be excluded.
Issue Date: 19-Dec-2018
Date of Acceptance: 29-Nov-2018
URI: http://hdl.handle.net/10044/1/66596
DOI: https://dx.doi.org/10.1136/archdischild-2018-315711
ISSN: 1359-2998
Publisher: BMJ Publishing Group
Journal / Book Title: Archives of Disease in Childhood. Fetal and Neonatal Edition
Copyright Statement: © Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.
Sponsor/Funder: Medical Research Council
Funder's Grant Number: MR/R001375/1
Keywords: hypoxic ischaemic encephalopathy
meta-analysis
newborn
therapeutic hypothermia
1114 Paediatrics And Reproductive Medicine
Pediatrics
Publication Status: Published online
Online Publication Date: 2018-12-19
Appears in Collections:Department of Medicine
Faculty of Medicine



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