THERAPEUTIC HYPOTHERMIA IN PATIENTS WITH HYPOXIC-

ISCHEMIC ENCEPHALOPATHY

MARQUES, F.D.A1, FERREIRA, G.L.M1, SANTANA, M.D1, CANGUSSU, L.A.R2

¹University of Itaúna medical students

2
University of Vale do Aço medical students

SUMMARY: The hypoxic-ischemic encephalopathy is a brain dysfunction caused by

the reduction of oxygen supply to the brain, associated with reduced blood supply. This
condition is one of the major causes of neurological mortality and morbidity in
newborns. The controlled therapeutic hypothermia has been studied in the last years
aiming the reduction of those rates, since the time of oxygen deprivation relates to the
level of injury to the brain, neurological delays, and also to the number of deaths.
OBJECTIVES: This literature review article has as objectives to evaluate the efficacy
and benefits of controlled therapeutic hypothermia in remission of future neurological
morbidities and prevention of deaths in newborns with perinatal asphyxia or hypoxia. It
also aims to observe the possible complications from using this procedure instead of the
other possible ones. METHODS: A bibliographic review was made through several
scientific articles found in the databases Scielo and PubMed. Nine articles were
selected, using as an inclusion and exclusion criteria the analysis of the objectives and
methods of the studies, and the year of publication (selecting those from 2014 to 2017).
RESULTS: When 1°C was reduced in the body temperature it was possible to decrease
the cerebral tissue metabolism in about 5%, that is, by controlled hypothermia we can
delay anoxic cellular depolarization, once the brain will need less oxygen and glucose
offer. In addition, the therapeutic hypothermia can block the pro-inflammatory route,
reducing the cytokines and adhesion molecules action, which when in a hypoxic state,
have neurotoxic effects. In experimental models using rodents, the prolonged
hypothermia was able to decrease the apoptosis and hypoxia in neuronal tissue, and in
children with hypoxic-ischemic encephalopathy, it could reduce the morbimortality,
mainly when associated with other neuroprotector factors, as quick evaluation and
treatment of endocrine and coagulation disorders. CONCLUSION: The use of
therapeutic hypothermia as a protocol in patients with perinatal asphyxia is associated
with long-term prognosis improvement in most patients. This technique has been
extremely effective in the reduction of neurological sequels, especially when it comes to
full-term newborns who have suffered from hypoxic-ischemic encephalopathy, and it
should be applied during the first hours, with monitoring and advanced support.

Flávia Domingues de Ávila Marques1

Larissa Anne Ruas Cangussu2

Marina Damiani Santana1

Giovanna Luiza Medina Ferreira1