Efficacy of passive hypothermia and adverse events during transport of asphyxiated newborns according to the severity of hypoxic-ischemic encephalopathy
Author
Carreras, Nuria
Alarcon, Ana
Arca-Díaz, Gemma
Agut, Thais
García-Alix, Alfredo
Publication date
2018Alternative title
Eficácia da hipotermia passiva e eventos adversos durante o transporte de recém-nascidos asfixiados de acordo com a gravidade da encefalopatia hipóxico-isquêmica
ISSN
0021-7557
Abstract
Objective: To determine if the efficacy of passive hypothermia and adverse events during transport are related to the severity of neonatal hypoxic-ischemic encephalopathy. Methods: This was a retrospective study of 67 infants with hypoxic-ischemic encephalopathy, born between April 2009 and December 2013, who were transferred for therapeutic hypothermia and cooled during transport. Results: Fifty-six newborns (84%) were transferred without external sources of heat and 11 (16%) needed an external heat source. The mean temperature at departure was 34.4 ± 1.4 °C and mean transfer time was 3.3 ± 2.0 h. Mean age at arrival was 5.6 ± 2.5 h. Temperature at arrival was between 33 and 35 °C in 41 (61%) infants, between 35 °C and 36.5 °C in 15 (22%) and <33 °C in 11 (16%). Infants with severe hypoxic-ischemic encephalopathy had greater risk of having an admission temperature < 33 °C (OR: 4.5; 95% CI: 1.1–19.3). The severity of hypoxic-ischemic encephalopathy and the umbilical artery pH were independent risk factors for a low temperature on admission (p < 0.05). Adverse events during transfer, mainly hypotension and bleeding from the endotracheal tube, occurred in 14 infants (21%), with no differences between infants with moderate or severe hypoxic-ischemic encephalopathy. Conclusion: The risk of overcooling during transport is greater in newborns with severe hypoxic-ischemic encephalopathy and those with more severe acidosis at birth. The most common adverse events during transport are related to physiological deterioration and bleeding from the endotracheal tube. This observation provides useful information to identify those asphyxiated infants who require closer clinical surveillance during transport.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
Keywords
Asfixia no nascimento
Encefalopatia hipóxico-isquêmica
Transporte neonatal
Hipotermia terapêutica
Resfriamento passivo
Termogênese
Birth asphyxia
Hypoxic-ischemic encephalopathy
Neonatal transport
Therapeutic hypothermia
Passive cooling
Thermogenesis
Pages
6
Publisher
Elsevier
Collection
94; 3
Is part of
Jornal de Pediatria
Citation
Carreras, Nuria; Alsina, Miguel; Alarcon, Ana [et al.]. Efficacy of passive hypothermia and adverse events during transport of asphyxiated newborns according to the severity of hypoxic-ischemic encephalopathy. Jornal de Pediatria, 2018, 94(3), p. 251-257. Disponible en: <https://www.sciencedirect.com/science/article/pii/S0021755717300372?via%3Dihub>. fecha de acceso: 7 feb. 2024. DOI: 10.1016/j.jped.2017.05.009
This item appears in the following Collection(s)
- Ciències de la Salut [745]
Rights
Under a Creative Commons license.