Hypothermia for moderate or severe neonatal encephalopathy in low-income and middle-income countries (HELIX): a randomised controlled trial in India, Sri Lanka, and Bangladesh.

Summary

HELIX was a multicentre open-label randomised controlled trial in seven tertiary neonatal units in India, Sri Lanka and Bangladesh comparing 72 h of whole-body therapeutic hypothermia with usual care in infants born at or after 36 weeks with moderate or severe neonatal encephalopathy. The primary combined outcome of death or moderate/severe disability at 18-22 months did not differ between groups, but mortality alone was significantly higher in the cooled group. The authors conclude that therapeutic hypothermia should not be offered for neonatal encephalopathy in low-income and middle-income settings, even where tertiary neonatal intensive care is available. Relevant to PICU and neonatal staff considering the transferability of high-income country neuroprotection evidence.

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