Scholarlink

Abstract <p>The role of therapeutic hypothermia (TH) in infants born at 35 weeks’ gestation remains uncertain, with discordant findings between randomized and observational studies and evolving clinical guidance. This commentary examines how this uncertainty has translated into substantial variability in clinical practice and highlights the limitations of relying on any single evidence source in isolation. Current American Academy of Pediatrics (AAP) guidance explicitly recommends parental discussion and shared decision-making (SDM) in this setting. We argue that care at 35 weeks represents a preference-sensitive clinical scenario in which SDM is essential but inconsistently implemented. Drawing on ethical frameworks and emerging neonatal neurocritical care models, we emphasize the importance of transparent communication, parental engagement, and clinician training in supporting decision-making. Finally, we discuss the need for pragmatic, parent-informed research approaches to generate timely and clinically meaningful evidence in this rare and complex population.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Clarifies uncertainty around therapeutic hypothermia at 35 weeks by integrating trial data, real-world evidence, and current guidelines.</p> </ItemContent> <ItemContent> <p>Demonstrates substantial practice variability, highlighting the need for more consistent, transparent decision-making.</p> </ItemContent> <ItemContent> <p>Positions shared decision-making (SDM) as a practical framework for preference-sensitive care in the NICU.</p> </ItemContent> <ItemContent> <p>Advocates for pragmatic, parent-informed research approaches to generate actionable evidence where trials are limited.</p> </ItemContent> </UnorderedList></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Therapeutic hypothermia at 35 weeks’ gestation: navigating controversy between randomized evidence, real-world practice, and shared decision-making

  • 期刊论文

  • 发表日期：

    2026年6月23日

查看全文
  • Mohamed El-Dib,
  • Terrie Inder,
  • Maggie Jalowsky,
  • Betsy Pilon,
  • Lina Chalak

摘要

Abstract

The role of therapeutic hypothermia (TH) in infants born at 35 weeks’ gestation remains uncertain, with discordant findings between randomized and observational studies and evolving clinical guidance. This commentary examines how this uncertainty has translated into substantial variability in clinical practice and highlights the limitations of relying on any single evidence source in isolation. Current American Academy of Pediatrics (AAP) guidance explicitly recommends parental discussion and shared decision-making (SDM) in this setting. We argue that care at 35 weeks represents a preference-sensitive clinical scenario in which SDM is essential but inconsistently implemented. Drawing on ethical frameworks and emerging neonatal neurocritical care models, we emphasize the importance of transparent communication, parental engagement, and clinician training in supporting decision-making. Finally, we discuss the need for pragmatic, parent-informed research approaches to generate timely and clinically meaningful evidence in this rare and complex population.

Impact

Clarifies uncertainty around therapeutic hypothermia at 35 weeks by integrating trial data, real-world evidence, and current guidelines.

Demonstrates substantial practice variability, highlighting the need for more consistent, transparent decision-making.

Positions shared decision-making (SDM) as a practical framework for preference-sensitive care in the NICU.

Advocates for pragmatic, parent-informed research approaches to generate actionable evidence where trials are limited.