Centre for Perinatal Neuroscience, Imperial College London, London, UK.
Neonatal Unit, Imperial College Healthcare NHS Trust, London, UK.
Arch Dis Child Fetal Neonatal Ed. 2020 Mar;105(2):225-228. doi: 10.1136/archdischild-2018-315711. Epub 2018 Dec 19.
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).
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.
Randomised and quasirandomised controlled trials comparing therapeutic hypothermia with usual care.
Safety and efficacy data extracted independently by two reviewers and analysed.
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)).
Current evidence is insufficient to recommend routine therapeutic hypothermia for babies with mild encephalopathy and significant benefits or harm cannot be excluded.
研究治疗性低温是否能降低轻度新生儿脑病（NE）后 18 个月或更长时间的死亡、中度或重度残疾的复合结局。
使用“缺氧缺血性脑病”、“新生儿”和“低温”作为医学主题词和术语，在 MEDLINE、Cochrane 数据库、Scopus 和 ISI Web of Knowledge 数据库中进行检索，并手动检索所有合格文章和主要综述文章的参考文献列表以及选定文章的相应作者的额外数据。
比较治疗性低温与常规治疗的随机和拟随机对照试验。
由两名评审员独立提取安全性和疗效数据并进行分析。
我们将中度和重度 NE 的五项冷却试验（两项全身冷却和三项选择性头部冷却）中意外纳入的 117 名轻度 NE 婴儿的数据纳入荟萃分析。在接受冷却治疗的 56 名婴儿中有 11 名（19.6%）和接受常规治疗的 61 名婴儿中有 12 名（19.7%）发生不良结局（风险比 1.11（95%置信区间 0.55 至 2.25））。
目前的证据不足以推荐常规治疗性低温治疗轻度脑病婴儿，不能排除其有显著的益处或危害。
