In:
Annals of Neurology, Wiley, Vol. 60, No. 5 ( 2006-11), p. 578-585
Kurzfassung:
Hypothermia was not neuroprotective in low body weight (BW) infants on subgroup analysis in a recent clinical trial of selective head cooling (SHC) in neonatal encephalopathy (CoolCap Trial). Methods The BW dependence of regional cerebral temperature was investigated in 14 newborn piglets under normothermia (38.5°C), whole‐body cooling (WBC; 36.5, 34.5, 32.5, and 30.5°C), or SHC (20, 15, and 10°C). Results Normothermia: Lower BW led to lower superficial brain temperature ( p 〈 0.01). Deep to superficial brain and rectal to superficial brain temperature gradients increased with decreasing BW (both p 〈 0.05). WBC: Lower BW led to lower superficial brain temperature and higher rectal to superficial brain temperature gradient ( p 〈 0.05 and p 〈 0.01, respectively). SHC: For lower BW, superficial and deep brain temperatures decreased ( p 〈 0.01 and p 〈 0.05, respectively), whereas rectal to deep, rectal to superficial, and deep to superficial brain temperature gradients increased ( p 〈 0.05, p 〈 0.01, and p 〈 0.05, respectively). Compared with SHC alone, superimposition of WBC (34.5°C) reduced all regional temperatures (all p 〈 0.001); gradients were unaffected. Interpretation Brain cooling (under normothermia, WBC, or SHC) was more efficient with lower BW due to greater head surface area‐to‐volume ratios. In the CoolCap Trial, low BW infants might have been excessively cooled. WBC and SHC may require BW adjustment to accomplish consistent regional temperatures and optimal neuroprotection. Ann Neurol 2006
Materialart:
Online-Ressource
ISSN:
0364-5134
,
1531-8249
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2006
ZDB Id:
2037912-2
