Hypothermia: A Neuroprotective Therapy for Neonatal Hypoxic-Ischemic Encephalopathy

To the Editor .— Recently, Blackmon et al1 reviewed the current evidence for the effectiveness and safety of hypothermia in newborns with hypoxic-ischemic encephalopathy (HIE). They urged caution in the interpretation of recently published randomized, controlled trials and argued that ongoing controlled trials of hypothermia should be completed. However, is it ethical for these trials to continue? All 3 trials of mild systemic hypothermia for infants with HIE showed a substantial reduction in the combined outcome of death or disability in neonates managed with hypothermia.2–4 In the published trials there were differences in methods for inducing hypothermia, inclusion criteria, and follow-up, but they have shown consistent benefit. These studies have been described as imperfect …