Avances del uso de la terapia hipotérmica en recién nacidos con encefalopatía hipóxico-isquémica

Abstract

Introduction: Hypothermic therapy is the preferred therapeutic management for treating neonatal patients diagnosed with moderate or severe hypoxic-ischemic encephalopathy, but during clinical practice, favorable results are obtained in patients with mild severity. It is performed by decreasing body temperature in three phases to achieve higher rates of neuroprotection. Objective: To detail the progress in the application of hypothermic therapy in newborns with hypoxic-ischemic encephalopathy. Methodology: A narrative literature review was carried out by searching scientific articles within the quartile 1-4 according to Scimago Journal & Country Rank, published in the last five years and retrieved from PubMed, Scopus, and Web of Science databases. Results: Hypothermic therapy has reduced mortality and disability with improved survival rates and neurological development. In addition, when used in the first 6 hours of life, it would help to improve short- and long-term psychomotor developmental indices. Neuromonitoring with amplitude-integrated electroencephalography can predict seizures and brain damage, providing timely prognostic value. Conclusions: Hypothermic therapy evidences a significant survival and neurodevelopmental rate, with reduced abnormalities, mortality, and disability. In addition, the therapeutic window should be reduced to 3 hours since it improves survival and psychomotor development. Finally, amplitude-integrated electroencephalography achieves prognostic effectiveness during its application with good availability and simple interpretation by medical personnel.