Therapeutic Hypothermia Remains Cornerstone of Newborn brain Injury Treatment, But Challenges to Wider Implementation Persist
ORLANDO, FL – Therapeutic hypothermia (HT) continues to be the primary neuroprotective strategy for hypoxic-ischemic encephalopathy (HIE) in newborns, but expanding its reach and maximizing its effectiveness requires careful attention to implementation details, according to presentations at PERINATO 2025. While proven beneficial when initiated early and delivered via established protocols, meaningful hurdles remain in translating research into consistent, real-world practice.
HIE,a brain injury caused by oxygen deprivation,affects thousands of newborns annually. Prompt cooling can mitigate long-term neurological damage, but achieving optimal outcomes hinges on factors beyond simply initiating hypothermia.These include stringent patient selection,robust infrastructure,continuous staff training,and ongoing research to refine the intervention’s precision and safety. The discussion at PERINATO 2025 underscored the need to balance the proven benefits of HT with the practical realities of resource allocation and implementation.
A key study highlighted during the conference, Affect of Therapeutic Hypothermia Initiated After 6 Hours of Age on Death or Disability Among Newborns With Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial (Laptook et al. 2017), suggested potential benefit even when cooling is initiated between 6 and 24 hours after birth. The study estimated a 76% probability of reducing death or disability, and a 64% probability of at least a 2% reduction in this outcome at 18 to 22 months. However, speakers emphasized that considerable uncertainty remains regarding the true magnitude of this later-initiated benefit.
The focus at PERINATO 2025 was not on abandoning established protocols for early cooling, but on optimizing the entire process. This includes ensuring appropriate infrastructure is available to support HT,ongoing training for medical teams,and continued research to improve the reach,precision,and safety of this critical intervention in modern perinatology. Ultimately, maximizing the impact of therapeutic hypothermia requires a commitment to both evidence-based practice and pragmatic implementation strategies.
