Outcomes in children treated with therapeutic hypothermia in the neonatal period

The aim of the work is to evaluate the long-term outcomes in children treated with therapeutic hypothermia in the early neonatal period by conducting a systematic review of available literature sources. Мaterial and methods: We conducted a systematic literature review using PubMed and the Cochrane Library. Selection criteria were randomized, controlled trials including children treated with therapeutic hypothermia in the early neonatal period. Exclusion criteria included publications with unspecified date and location. No language restrictions were applied. Results: We reviewed 30 literature sources from 2011 to 2022. A number of child follow-up studies confirm that therapeutic hypothermia improves not only neonatal outcomes but also reduces disability before 18 months of life. Neurologic outcome in children treated with therapeutic hypothermia in the neonatal period was assessed from 18 months to 8 years of age. Based on a careful selection of information, it was found that children who underwent therapeutic hypothermia in the early neonatal period had cognitive and motor impairment, difficulty in concentration, slow reaction time and decreased visual-spatial processing at school age. Conclusions: At present, therapeutic hypothermia is the latest method of treatment for neonates with severe neonatal encephalopathy, based on neurobiological advances and is recognized by clinicians worldwide as an effective method. However, studies show maximum effectiveness of this method in assessing short-term outcomes and ambiguous assessment of long-term outcomes. The presence of a possible neurological deficit in children treated with therapeutic hypothermia in the early neonatal period dictates the development of an individual algorithm for monitoring this category of newborns with an early start of habilitative neuroprotective measures followed by annual cognitive and motor tests until the patients are transferred to the adult network.