Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia
Introduction Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. Methods Prospective-observational study (April 18 2018 – November 19 2019). Newborns (≥34 weeks of gestational age (GA) and >1800 g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. Results 51 newborns. The median stabilisation and transport time were 68 min (p25–75, 45–85 min) and 30 min (p25–75, 15–45 min), respectively. The mean age at arrival at the receiving unit was 4 h and 18 min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There were no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. Conclusions Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies.
Neonatal transport; Hypoxic-ischemic encephalopathy; Hypothermia
Torre Monmany N, Maya Gallego S, Esclapés Giménez T, Sardà Sánchez M, Rodríguez Losada O, Martínez Planas A, et al. Retos en la aplicación de la hipotermia terapéutica no servo-controlada durante el transporte neonatal en Cataluña. An Pediatría. 2021 Dec;95(6):459–66.
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