HIE EBNEO review on topiramate and therapeutic hypothermia to reduce seizure burden in infants with HIE
THERAPEUTIC HYPOTHERMIA Therapeutic hypothermia is commonly initiated within 6 hours of birth to treat neonates displaying symptoms of HIE; however, whether therapeutic hypothermia is an effective treatment modality for neonates > 6 hours of age is unknown. This randomized controlled trial assessed the effectiveness of therapeutic hypothermia lasting 96 hours in infants between 6 and 24 hours of age, and demonstrated a minor benefit to initiating late therapeutic hypothermia. Thus, therapeutic hypothermia can be considered in infants > 6 hours of age.
HYPOXIC ISCHEMIC ENCEPHALOPATHY HIE is commonly treated with therapeutic hypothermia, but erythropoeitin (EPO) exists both as a monotherapy and an adjunct therapeutic option. This randomized controlled trial studied the use of EPO monotherapy initiated within 6 hours of birth in preventing death or severe disability at 19 months of age in term neonates with moderate or severe HIE. Although further analysis is needed, the trial revealed that EPO monotherapy reduces the risk of death or disability compared to placebo.
HIE Hypoxic-Ischemic Encephalopathy is a common cause of disability or death among full term neonates who experienced perinatal asphyxia. This randomized control trial sought to determine the most effective temperature and duration of therapeutic hypothermia. The study found no reduction in mortality with either longer, deeper, or combined lengthened and deeper cooling. Though follow-up data remains to be collected, longer and deeper cooling cannot currently be recommended as therapies for HIE.