Neonatal Unit, Princess of Wales Maternity Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Ther Hypothermia Temp Manag. 2022 Mar;12(1):43-46. doi: 10.1089/ther.2021.0015. Epub 2021 Sep 9.
Hydrops fetalis (HF) is a serious fetal condition. Infants born with HF are often critically unwell, requiring resuscitation and prolonged intensive care admission. Despite medical advances, morbidity and mortality remain high. Therapeutic hypothermia is the standard of care for term and late preterm infants with moderate-to-severe hypoxic-ischemic encephalopathy (HIE), as it improves neurodevelopmental outcomes in surviving infants. To our knowledge, the use of therapeutic hypothermia has not previously been reported in infants with HF. We report the case of a term infant with undiagnosed HF, who required resuscitation and received 72 hours of therapeutic hypothermia for moderate HIE. We describe the cardiovascular instability encountered during therapeutic hypothermia and how it was successfully managed. She responded well to treatment and was discharged home bottle-feeding, with normal neurology and a normal brain magnetic resonance imaging scan. From this case, therapeutic hypothermia in infants with HF and HIE is feasible and can be beneficial in carefully selected HF infants meeting cooling criteria.
胎儿水肿（HF）是一种严重的胎儿病症。患有 HF 的婴儿通常病情危急，需要复苏和长时间的重症监护入院治疗。尽管医疗技术有所进步，但发病率和死亡率仍然很高。对于足月和晚期早产儿中中重度缺氧缺血性脑病（HIE），治疗性低温是标准治疗方法，因为它可以改善存活婴儿的神经发育结局。据我们所知，HF 婴儿中以前没有报告使用治疗性低温。我们报告了一例足月婴儿，患有未确诊的 HF，需要复苏，并因中度 HIE 接受了 72 小时的治疗性低温治疗。我们描述了治疗性低温期间遇到的心血管不稳定情况，以及如何成功地进行了管理。她对治疗反应良好，出院后在家用奶瓶喂养，神经功能正常，脑部磁共振成像扫描正常。从这个病例中可以看出，HF 和 HIE 婴儿的治疗性低温是可行的，并且可以在满足冷却标准的情况下，对精心挑选的 HF 婴儿有益。
