Servo-controlled therapeutic hypothermia during neonatal transport: a before-and-after quality improvement project.
Eur J Pediatr
; 183(10): 4259-4264, 2024 Oct.
Article
en En
| MEDLINE
| ID: mdl-39028371
ABSTRACT
The purpose of this paper is to compare the achievement of target temperature and the short-term neurological outcome according to the use of servo-controlled hypothermia in transport. This is a monocentric retrospective observational before-and-after uncontrolled study of newborns transported for neonatal encephalopathy. The first group was transported from 01/01/2019 to 12/31/2019 in passive hypothermia and the second group from 01/01/2021 to 12/31/2021 in controlled hypothermia. We included patients who had a total of 72 h of servo-controlled therapeutic hypothermia (CTH). We excluded those who had no or less than 72 h of CTH. There were 33 children transported in passive hypothermia in 2019 and 23 children transported in CTH in 2021. There were 9/28 (32%) patients in 2019 who reached the target temperature on arrival at the NICU compared with 20/20 (100%) in 2021 (p value < 0.01). There was a trend towards earlier age of therapeutic hypothermia if started in transport 3.1 h ± 1.0 vs 4.0 h ± 2.4 for passive hypothermia (p value 0.07). There was no difference in age of arrival in NICU (4.0 h ± 1.2 with CTH vs 3.8 h ± 2.2 without CTH). We found no difference in short-term outcome (survival, abnormal MRI, seizures on EEG) between the two groups. CONCLUSION:
The use of servo-controlled therapeutic hypothermia makes it possible to reach the temperature target, without increasing the age of arrival in the NICU. WHAT IS KNOWN ⢠CTH is rarely used during transport in France even if passive hypothermia rarely reaches temperature target, inducing overcooling and hyperthermia. WHAT IS NEW ⢠This study shows better temperature control on arrival in the NICU with CTH compared to passive hypothermia, with no increase in arrival time.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Transporte de Pacientes
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Mejoramiento de la Calidad
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Hipotermia Inducida
Límite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Revista:
Eur J Pediatr
Año:
2024
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Alemania