Therapeutic Hypothermia in Brazil: A MultiProfessional National Survey.
Am J Perinatol
; 36(11): 1150-1156, 2019 09.
Article
in En
| MEDLINE
| ID: mdl-30553235
ABSTRACT
OBJECTIVE:
To determine the rate of therapeutic hypothermia (TH) use, current practices, and long-term follow-up. STUDYDESIGN:
Prospective cross-sectional national survey with 19 questions related to the assessment of hypoxic-ischemic encephalopathy (HIE) and TH practices. An online questionnaire was made available to health care professionals working in neonatal care in Brazil.RESULTS:
A total of 1,092 professionals replied, of which 681 (62%) reported using TH in their units. Of these, 624 (92%) provided TH practices details 136 (20%) did not use any neurologic score or amplitude-integrated electroencephalogram (aEEG) to assess encephalopathy and 81(13%) did not answer this question. Any specific training for encephalopathy assessment was provided to only 81/407 (19%) professionals. Infants with mild HIE are cooled according to 184 (29%) of the respondents. Significant variations in practice were noticed concerning time of initiation and cooling methods, site of temperature measurements and monitoring, and access to aEEG, electroencephalogram (EEG), and neurology consultation. Only 19% could perform a brain magnetic resonance imaging (MRI), and 31% reported having a well-established follow-up program for these infants.CONCLUSION:
TH has been implemented in Brazil but with significant heterogeneity for most aspects of hypothermia practices, which may affect safety or efficacy of the therapy. A step forward toward quality improvement is important.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Practice Patterns, Physicians'
/
Intensive Care, Neonatal
/
Hypothermia, Induced
Type of study:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Newborn
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Am J Perinatol
Year:
2019
Type:
Article
Affiliation country:
Brazil