Initiation of passive cooling at referring centre is most predictive of achieving early therapeutic hypothermia in asphyxiated newborns

Paediatrics & Child Health
Brigitte LemyreSteven P Miller

Abstract

To identify factors associated with early initiation and achievement of therapeutic hypothermia (TH) in newborns with hypoxic-ischemic encephalopathy (HIE). Retrospective cohort study of newborns who received TH according to National Institute of Child Health and Human Development (NICHD) criteria in two academic level 3 Neonatal Intensive Care Units (NICU) between 2009 and 2013. All infants were transported by a neonatal transport team (NNTT). Multivariate linear regression including who initiated cooling and degree of resuscitation in the model was performed. Two hundred and seven infants were included. Waiting for advice from a tertiary care NICU was independently associated with a 50 minute delay in the median time of initiation of TH. The need for extensive resuscitation (cardiopulmonary resuscitation [CPR] or epinephrine) was independently associated with a reduction of 43 minutes in the median time to reach target core temperature. Log-transformed time to initiation of TH was associated with time to reach target core temperature (P<0.001). A doubling of time to initiation of TH corresponds to a 24% (95% CI 18% to 30%) increase in median time to reach target core temperature. Initiating passive cooling at the referring ce...Continue Reading

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Citations

Jan 15, 2019·Current Neurology and Neuroscience Reports·Guido WassinkAlistair J Gunn
Jan 18, 2019·Paediatrics & Child Health·Brigitte Lemyre, Vann Chau
Apr 14, 2021·Pediatric Research·Kennosuke TsudaUNKNOWN Baby Cooling Registry of Japan
Sep 1, 2021·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·Nuria Torre MonmanyElisabeth Esteban

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