Abstract
Introduction: Inspite of the improvements in the general management of the asphxiated term infant, the best strategy for neuroprotection and the prevention of further brain damage is still unclear.
Objective: to report a case of severely asphyxiated term newborn, treated with whole body hypothermia.
Case: A 38 week gestational newborn, developed acute fetal distress during induction. Birth weight of 4 545 kg, apgar 1, 3, 5 requiring intubation and mechanical ventilation for persistent apnea. Severe acidosis, with BE of -21mEq/t was detected within 30 min from birth. After 2 hours there were signs of a grade II hypoxic ischaemic encephalopathy with an EEG showing diffuse amplitude depression. Total body hypothermia was started at 6 hours, with lowering of the rectal temperature to 33-34º C for 72 hours. There were no adverse side effects and the patient was discharged at day 10 with a normal neurological examination. After 2 years of follow up there is normal psychomotor development.
Conclusion: Whole body hypothermia is feasible in selected patients if well defined criterias, preciously initiated (within 6 hours of birth) and training nurse and adequate equipment are available.
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