Neonatal asphyxia pallida treated with hypothermia alone or with hypothermia and transfusion of oxygenated blood.

Abstract

R ESULTS with experimenta, animals (guinea pigs, rabbits, and puppies) have shown that reduction of colonic temperature is very effective in preventing death from experimental asphyxia with 95 per cent N? plus 5 per cent C(),.5-s~ la Even in guinea pigs, which at birth behave much more like adults than babies, a 10’ C. reduction in body temperature will completely protect, 100 per cent of the animals from an exposure which is lethal for IO0 per cent of the control littermates.8l I3 On the other hand, premature humans not only tolerate low body temperatures, but under certain circumstances at least, live longer when cool than when at normal temperature. Nonviable npneic premature humans can be maintained for 12 hours or more with perfusion of oxyg.enated blood i-f kept at 25O (-1. body temperature, whereas theit hearts stop within 60 to 90 minutes if they are kept at 37’ C.” One 580 gram infant was maintained for 21 hours at temperatures below 22O (‘. During this time it was cooled to less than 4O C. on five separate occasions. Its temperature reached 0.1.’ C. during the last two episod.es. This temperature produced asystole, but cardiac contractions recommenced ,spontaneously upon rewarming.‘l In addition, in experimental animals hypothermia has been found to potentiate the beneficial effects of injected Nembutal, nucleotide, and hydrogen peroxide.8 Thus the time appeared ripe for a clinical trial of hypothermia as an adjunct to other resuscitative measures for asphyxia neonatorum.