Consensus statement on integral management of the newborn with hypoxic-ischemic encephalopathy

Abstract

Neonatal encephalopathy secondary to birth asphyxia,the hypoxic ischemic encephalopathy, remains a major cause of postnatal death and neurological sequelae worldwide. Supportive therapy has been the mainstay of treatment. Recently series of multicenter clinical trials show the benefits of therapeutic hypothermia in this high risk population. The International Liaison Committee on Resuscitation (ILCOR) has recommended hypothermia as a standard of care and a beneficial therapy using the protocols followed in large clinical trials. Our objective was to develop a practical guide to be used at a national level in Chile, compatible with published protocols and standardized on an international basis, practical and compatible with the country's situation, and considering an integral management of the asphyxiated neonates, rescue and neuroprotective therapies. In summary, to establish rescue therapies, with the aim objective of support measures that promote cerebral and systemic oxygenation/perfusion, ensuring optimal cellular homeostasis, which are the basis of the rescue measures in asphyxiated neonates. Along with these rescue therapies, the objective is to perform the more beneficial neuroprotective therapy known today, hypothermia. Hypothermia should be conducted in a level 3 Neonatal Intensive Care Unit, with multidisciplinary care and standardized protocols and also multidisciplinary follow-up and rehabilitation therapies.