Does head cooling with mild systemic hypothermia affect requirement for blood pressure support?
OBJECTIVE: Our goal was to evaluate whether head cooling with mild systemic hypothermia for neonatal encephalopathy is associated with greater requirement for volume or inotrope support. PATIENTS AND METHODS: We studied term infants (>/=36 weeks) with moderate-to-severe neonatal encephalopathy plus abnormal amplitude integrated electroencephalography, randomly assigned to head cooling for 72 hours starting within 6 hours of birth, with the rectal temperature maintained at 34.5 degrees C +/- 0.5 degrees C (n = 112), or conventional care (n = 118). DESIGN: This was a multicenter randomized, controlled study (the CoolCap trial). The primary outcome was the time relationship between mean arterial blood pressure and subsequent administration of inotropes or volume administration. RESULTS: Pooled data from 0 to 76 hours after randomization revealed no difference in mean arterial blood pressure between groups and significantly lower mean heart rate during cooling. The use of inotropes or volu
