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    Munroe PB, Addison S, Abrams DJ, Sebire NJ, Cartwright J, Donaldson I, Cohen MM, Mein C, Tinker A, Harmer SC, Aziz Q, Terry A, Struebig M, Warren HR, Vadgama B, Fowler DJ, Peebles D, Taylor AM, Lally PJ, Thayyil Set al., 2018,

    Postmortem Genetic Testing for Cardiac Ion Channelopathies in Stillbirths

    Oliveira V, Kumutha JR E N, Somanna J, Benkappa N, Bandya P, Chandrasekeran M, Swamy R, Mondkar J, Dewang K, Manerkar S, Sundaram M, Chinathambi K, Bharadwaj S, Bhat V, Madhava V, Nair M, Lally PJ, Montaldo P, Atreja G, Mendoza J, Bassett P, Ramji S, Shankaran S, Thayyil Set al., 2018,

    Hypothermia for encephalopathy in low-income and middle-income countries: feasibility of whole-body cooling using a low-cost servo-controlled device.

    , BMJ Paediatr Open, Vol: 2

    Although therapeutic hypothermia (TH) is the standard of care for hypoxic ischaemic encephalopathy in high-income countries, the safety and efficacy of this therapy in low-income and middle-income countries (LMICs) is unknown. We aimed to describe the feasibility of TH using a low-cost servo-controlled cooling device and the short-term outcomes of the cooled babies in LMIC. Design: We recruited babies with moderate or severe hypoxic ischaemic encephalopathy (aged <6 hours) admitted to public sector tertiary neonatal units in India over a 28-month period. We administered whole-body cooling (set core temperature 33.5°C) using a servo-controlled device for 72 hours, followed by passive rewarming. We collected the data on short-term neonatal outcomes prior to hospital discharge. Results: Eighty-two babies were included-61 (74%) had moderate and 21 (26%) had severe encephalopathy. Mean (SD) hypothermia cooling induction time was 1.7 hour (1.5) and the effective cooling time 95% (0.08). The mean (SD) hypothermia induction time was 1.7 hour (1.5 hour), core temperature during cooling was 33.4°C (0.2), rewarming rate was 0.34°C (0.16°C) per hour and the effective cooling time was 95% (8%). Twenty-five (51%) babies had gastric bleeds, 6 (12%) had pulmonary bleeds and 21 (27%) had meconium on delivery. Fifteen (18%) babies died before discharge from hospital. Heart rate more than 120 bpm during cooling (P=0.01) and gastric bleeds (P<0.001) were associated with neonatal mortality. Conclusions: The low-cost servo-controlled cooling device maintained the core temperature well within the target range. Adequately powered clinical trials are required to establish the safety and efficacy of TH in LMICs. Clinical trial registration number: NCT01760629.

    Prempunpong C, Chalak LF, Garfinkle J, Shah B, Kalra V, Rollins N, Boyle R, Nguyen K-A, Mir I, Pappas A, Montaldo P, Thayyil S, Sanchez PJ, Shankaran S, Laptook AR, Sant'Anna Get al., 2018,

    Prospective research on infants with mild encephalopathy: the PRIME study

    , JOURNAL OF PERINATOLOGY, Vol: 38, Pages: 80-85, ISSN: 0743-8346
    Thayyil S, 2018,

    Cooling Therapy for Neonatal Encephalopathy in Low- and Middle-income Countries.

    , Indian Pediatrics, Vol: 55, Pages: 197-198, ISSN: 0019-6061
    Thayyil S, Shankaran S, 2018,

    Current Status of Therapeutic Hypothermia in India: Few Concerns Reply

    , INDIAN PEDIATRICS, Vol: 55, Pages: 347-348, ISSN: 0019-6061
    Ahmed MU, Chanwimalueang T, Thayyil S, Mandic DPet al., 2017,

    A Multivariate Multiscale Fuzzy Entropy Algorithm with Application to Uterine EMG Complexity Analysis

    , ENTROPY, Vol: 19, ISSN: 1099-4300
    Chalak LF, Prempunpong C, Garfinkle J, Rollins N, Nguyen K-A, Pappas A, Montaldo P, Thayyil S, Sanchez PJ, Shankaran S, Laptook AR, Sant'Anna Get al., 2017,


    , Publisher: WILEY, Pages: 9-9, ISSN: 0803-5253
    Chandrasekaran M, Chaban B, Montaldo P, Thayyil Set al., 2017,

    Predictive value of amplitude-integrated EEG (aEEG) after rescue hypothermic neuroprotection for hypoxic ischemic encephalopathy: a meta-analysis

    , JOURNAL OF PERINATOLOGY, Vol: 37, Pages: 684-689, ISSN: 0743-8346
    Chandrasekaran M, Swamy R, Ramji S, Shankaran S, Thayyil Set al., 2017,

    Therapeutic hypothermia for neonatal encephalopathy in Indian neonatal units: A survey of national practices

    , INDIAN PEDIATRICS, Vol: 54, Pages: 969-970, ISSN: 0019-6061
    Lally PJ, Montaldo P, Oliveira V, Swamy RS, Soe A, Shankaran S, Thayyil Set al., 2017,

    Residual brain injury after early discontinuation of cooling therapy in mild neonatal encephalopathy.

    , Arch Dis Child Fetal Neonatal Ed

    We examined the brain injury and neurodevelopmental outcomes in a prospective cohort of 10 babies with mild encephalopathy who had early cessation of cooling therapy. All babies had MRI and spectroscopy within 2 weeks after birth and neurodevelopmental assessment at 2 years. Cooling was prematurely discontinued at a median age of 9 hours (IQR 5-13) due to rapid clinical improvement. Five (50%) had injury on MRI or spectroscopy, and two (20%) had an abnormal neurodevelopmental outcome at 2 years. Premature cessation of cooling therapy in babies with mild neonatal encephalopathy does not exclude residual brain injury and adverse long-term neurodevelopmental outcomes. This study refers to babies recruited into the MARBLE study (NCT01309711, pre-results stage).

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