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Introduction: Hypoxic-ischemic encephalopathy (HIE) affects around 1.5 per 1,000 live births and is one of the main causes of neonatal mortality and neurological impairment. Therapeutic hypothermia (TH), started in the first six hours of life, has been shown to significantly reduce mortality and disabilities at 18 months and is recommended internationally in moderate to severe cases. Systemic cooling between 33°C and 34°C for 72 hours is the most widely used protocol, although its effectiveness in premature infants is still unclear. Clinical assessment, especially using the modified Sarnat score, and team training are essential for successful treatment and for promoting neuropsychomotor development (NPMD), a multifactorial process influenced by genetic, environmental and family factors. In view of this, this study aims to review the efficacy and safety of hypothermia in the treatment of HIE in neonates and its impact on neuropsychomotor development. Methodology: This study carried out an integrative literature review, between February and March 2025, on the SciELO, PubMed and VHL databases, using specific descriptors. Of the 384 articles found, 10 made up the final sample, respecting inclusion criteria such as language, year of publication and type of study. Articles prior to 2017, observational studies and narrative reviews were excluded. Results and discussion: The results showed that the effectiveness of HT depends on individualized assessment. Although studies indicate risks in stopping treatment before 72 hours, its efficacy in mild IHE remains controversial. The lack of standardization between centers contributes to variations in outcomes. HT has been shown to be effective in reducing seizures, hospital costs and inflammatory markers. Continuing education programs and the use of telemedicine have contributed to better clinical practices. Conclusion: HT is effective in moderate to severe IHE, but its use in mild cases or in premature infants lacks evidence. Standardization of protocols, monitoring and more research are needed to ensure safety, effectiveness and a positive impact on health policies
References
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Copyright (c) 2025 Yasmim Karolaine Gomes Delgado , Tarcísio Pereira Vasconcelos Neto, Roberta Marques da Silva, Talita Maria Araújo de Abreu, Larissa Thaís Ferreira de Luna Gomes Delfino, Maria Rayane de Paiva Rodrigues, Raquel alves da Costa, Lizandra Cecília Andrade Pereira, Amanda Valeska do Nascimento Duarte Mendonça, Ana Beatriz Sampaio Casé, Matheus William Medeiros da Paz, Wliana Lara Moreira Menezes
