Tip 245: the TOBY study

The TOBY (TOtal BodY hypothermia for perinatal asphyxial encephalopathy) study used moderate hypothermia (33.5°C for 72 hours) in neonates ≥36/40 with the primary outcome of death or severe disability at 18 months of age.

The study did not prove a reduction in either death, severe disability or these combined (RR of death or severe disability 0.86; 95% CI, 0.68 to 1.07; P=0.17).

However, it did show improved survival without neurological abnormality (RR 1.57; 95% CI, 1.16 to 2.12; P=0.003).

Reference: Azzopardi, D. V., Strohm, B., Edwards, A. D., Dyet, L., Halliday, H. L., Juszczak, E., … & Brocklehurst, P. (2009). Moderate hypothermia to treat perinatal asphyxial encephalopathy. New England Journal of Medicine; 361(14): 1349-1358 (325 babies).

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