Hindawi Publishing Corporation ISRN Pediatrics Volume 2013, Article ID 140213, 6 pages http://dx.doi.org/10.1155/2013/140213 Clinical Study Heart Rate and Arterial Pressure Changes during Whole-Body Deep Hypothermia Giacomo Cavallaro, 1 Luca Filippi, 2 Genny Raffaeli, 1 Gloria Cristofori, 1 Federico Schena, 1 Elisa Agazzani, 3 Ilaria Amodeo, 1 Alice Griggio, 1 Simona Boccacci, 3 Patrizio Fiorini, 2 and Fabio Mosca 1 1 NICU, Fondazione IRCCS C` a Granda, Ospedale Maggiore Policlinico, Universit` a degli Studi di Milano, Via Della Commenda 12, 20122 Milan, Italy 2 NICU, Medical Surgical Feto-Neonatal Department, “A. Meyer” University Children’s Hospital, Viale G. Pieraccini, 24, 50139 Florence, Italy 3 Neonatal Intensive Care Unit, “Carlo Poma” Hospital, Mantova, Italy Correspondence should be addressed to Giacomo Cavallaro; giacomo.cavallaro@mangiagalli.it Received 31 January 2013; Accepted 18 March 2013 Academic Editors: A. Maheshwari and B. Vasarhelyi Copyright © 2013 Giacomo Cavallaro et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Whole-body deep hypothermia (DH) could be a new therapeutic strategy for asphyxiated newborn. his retrospective study describes how DH modiied the heart rate and arterial blood pressure if compared to mild hypothermia (MH). Fourteen in DH and 17 in MH were cooled within the irst six hours of life and for the following 72 hours. Hypothermia criteria were gestational age ≥ 36 weeks; birth weight ≥ 1800 g; clinical signs of moderate/severe hypoxic-ischemic encephalopathy. Rewarming was obtained in the following 6–12 hours (0.5 ∘ C/h) ater cooling. Heart rates were the same between the two groups; there was statistically signiicant diference at the beginning of hypothermia and during rewarming. hree babies in the DH group and 2 in the MH group showed HR < 80 bpm and QTc > 520 ms. Infant submitted to deep hypothermia had not bradycardia or Qtc elongation before cooling and ater rewarming. Blood pressure was signiicantly lower in DH compared to MH during the cooling, and peculiar was the hypotension during rewarming in DH group. Conclusion. he deeper hypothermia is a safe and feasible, only if it is performed by a well-trained team. DH should only be associated with a clinical trial and prospective randomized trials to validate its use. 1. Introduction Hypoxic-ischemic encephalopathy (HIE) is a disease that induces death and severe neurological damage in newborns [1]. Hypothermia is now the irst efective neuroprotective intervention for newborns that are critically ill following an asphyxial insult. Hypothermia showed a decrease in death or disability at 18 months [2–5]. Parkins et al. irstly introduced hypothermia as a neuroprotective method, but the side efects were higher, so the practice had been abandoned [6]. Meta- analysis about eight largest RCTs had conirmed that cooling reduced mortality without increasing handicap in survivors [7]. Two meta-analyses have conirmed that hypothermia was associated with a lower risk of death or moderate/severe neurodevelopmental disorder in childhood, but with an increased risk of arrhythmia and thrombocytopenia [8, 9]. Perlman suggested that deeper or more prolonged cooling could be able to treat more severe neonatal asphyxia [2]. he early studies of deep hypothermia (20–27 ∘ C) have found some neurological beneits, but the side efects dramatically increased below 32 ∘ C and passed all potential clinical ben- eits [10]. Shivering and cardiac arrhythmias were the most pronounced of these side efects [11, 12]. Cardiac arrhythmias, hypotension, hemoconcentration, sinus bradycardia, and peripheral vasoconstriction are common adverse events in neonatal hypothermia [13–15]. Safety and respiratory func- tion during deep hypothermia (DH) in asphyxiated newborn were previously reported [16, 17]. Retrospective analysis of circulatory parameters is part of a prospective study designed to investigate the safety of the topiramate [18, 19].