Abstract:OBJECTIVE: To study the clinical safety and neurop rotection of selective brain hypothermia for full-term neonates with hypoxic-i sch emic brain damage(HIBD) following perinatal asphyxia. METHODS: Twenty-two severe asyxiated neonates were randomly assigned into the treatment group(n=11) a nd the control group(n=11). Besides the routine treatment, brain hypothermia was us ed in the treatment group and their nasopharyngeal temperature was maintained a t(34.0±0.2)℃for 72 hours. The control group neonates received routine treatment. Neuron-specific enolase(NSE) in the cerebrospinal fluid(CSF), serum CK - MB a nd urine β2-microglobulin(β2-MG) were measured in the two groups between 6 4 and 72 hours after the treatment. EEG was recorded at 6 hours, 10 days and 3 months af ter birth. Neurodevelopmental assessment was done with neonatal behavioral neurological assessment(NBNA) at 10 and 28 days of life and with CDCC at 3 months after birth. RESULTS: NSE in the control group was higher than that in the tre atment group [(24.6±5.3) μg/L vs(19.5±2.2)μg/L](P < 0.01). NBNA of t he treatment group(36±3) sh owed improvement at 28 days after birth compared with that in the control group (32±2)(P < 0.01). In the treatment group, EEG normalized at 10 days and 3 months after birth respectively. However,EEG of 2 patients in the control group remai n ed abnormal. Serum CK-MB and urine β2-MG were elevated in the 2 groups, but no significant difference was noted.CONCLUSIONS: Selective brain hypothermia may be useful and safe for neuroprotection in full-term neonates with HIBD following perinatal asphyxia .
