Persistent Pulmonary Hypertension Among Infants Undergoing Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy: A Systematic Review and Meta-Analysis.
Rashida Javed, Tim J Van Hasselt, Narasimha Rao et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis examined whether therapeutic hypothermia (TH), compared with no TH or usual care, was associated with persistent pulmonary hypertension (PPHN) in infants with moderate to severe hypoxic-ischemic encephalopathy. Seven randomized controlled trials, including 1006 infants, contributed to the meta-analysis. The pooled relative risk of PPHN with TH versus no TH was 1.13 (95% confidence interval 0.81 to 1.57), providing no evidence of an association. The review also assessed nine observational studies narratively and noted that PPHN occurred in both treatment groups.
Key findings
- Across seven randomized trials involving 1006 infants, the relative risk of PPHN with TH versus no TH was 1.13 (95% confidence interval 0.81 to 1.57).
- The review found no evidence of an association between TH and PPHN in infants with moderate to severe HIE.
- The authors noted that a considerable number of infants developed PPHN in both TH and no-TH groups.
Why it matters
PPHN occurred in infants with moderate to severe HIE whether or not they received therapeutic hypothermia. The pooled trial evidence did not show an association with TH, but the outcome remains clinically relevant in this population. Awareness of its occurrence can support timely investigation and management, as the authors suggest.
What to keep in mind
The review noted risk of bias related to blinding participants in the included randomized trials. The meta-analysis included seven trials; observational studies were reviewed narratively rather than pooled.