Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia
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. Prospective-observational study (April 18 2018 –...
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| Veröffentlicht in: | Anales de Pediatría 2021-12, Vol.95 (6), p.459-466 |
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| creator | Torre Monmany, Nuria Maya Gallego, Sara Esclapés Giménez, Teresa Sardà Sánchez, Marta Rodríguez Losada, Olalla Martínez Planas, Aina Oller Fradera, Olga Alarcón, Ana Esteban, Elisabeth |
| description | 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.
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.
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.
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.
La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR), requiriendo ser transportados.
Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019).
51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controla |
| doi_str_mv | 10.1016/j.anpede.2021.07.005 |
| format | Article |
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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.
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.
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.
La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR), requiriendo ser transportados.
Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019).
51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo.
La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR.</description><identifier>ISSN: 2341-2879</identifier><identifier>EISSN: 2341-2879</identifier><identifier>DOI: 10.1016/j.anpede.2021.07.005</identifier><identifier>PMID: 34462230</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Asfixia neonatal ; Asphyxia neonatorum ; Encefalopatía hipoxico-isquémica ; Hipotermia pasiva ; Hipotermia servo-controlada ; Hipotermia terapéutica ; Hypoxic-ischemic encephalopathy ; Neonatal transport ; Passive cooling ; Servo-controlled cooling ; Therapeutic hypothermia ; Transporte neonatal</subject><ispartof>Anales de Pediatría, 2021-12, Vol.95 (6), p.459-466</ispartof><rights>2021 Asociación Española de Pediatría</rights><rights>Copyright © 2021 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2535-9cb0bdebdd62416e9d622b9e2dcaba012784fecb855af60450d81ccbacdf025d3</citedby><cites>FETCH-LOGICAL-c2535-9cb0bdebdd62416e9d622b9e2dcaba012784fecb855af60450d81ccbacdf025d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34462230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Torre Monmany, Nuria</creatorcontrib><creatorcontrib>Maya Gallego, Sara</creatorcontrib><creatorcontrib>Esclapés Giménez, Teresa</creatorcontrib><creatorcontrib>Sardà Sánchez, Marta</creatorcontrib><creatorcontrib>Rodríguez Losada, Olalla</creatorcontrib><creatorcontrib>Martínez Planas, Aina</creatorcontrib><creatorcontrib>Oller Fradera, Olga</creatorcontrib><creatorcontrib>Alarcón, Ana</creatorcontrib><creatorcontrib>Esteban, Elisabeth</creatorcontrib><title>Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia</title><title>Anales de Pediatría</title><addtitle>An Pediatr (Engl Ed)</addtitle><description>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.
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.
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.
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.
La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR), requiriendo ser transportados.
Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019).
51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo.
La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR.</description><subject>Asfixia neonatal</subject><subject>Asphyxia neonatorum</subject><subject>Encefalopatía hipoxico-isquémica</subject><subject>Hipotermia pasiva</subject><subject>Hipotermia servo-controlada</subject><subject>Hipotermia terapéutica</subject><subject>Hypoxic-ischemic encephalopathy</subject><subject>Neonatal transport</subject><subject>Passive cooling</subject><subject>Servo-controlled cooling</subject><subject>Therapeutic hypothermia</subject><subject>Transporte neonatal</subject><issn>2341-2879</issn><issn>2341-2879</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kE2LFDEQhoMo7rLuPxDJ0Uu3lXT66yLI4Kqw4EXPoTqp3snQk7RJemH_vWlmFU-eKgnPW1V5GHsroBYgug-nGv1KlmoJUtTQ1wDtC3YtGyUqOfTjy3_OV-w2pRMAyEY0repes6tGqU7KBq5ZOhxxWcg_UOLO83wkjuu6OIPZBc_DzH3wVaL4GEzwOYYC2x2LuNKWneHHpzXs97NDbrfo_AP3FDxmXHiO6NMaYt57H_an4B2-Ya9mXBLdPtcb9vPu84_D1-r--5dvh0_3lZFt01ajmWCyNFnbSSU6GkuV00jSGpwQhOwHNZOZhrbFuQPVgh2EMRMaO4NsbXPD3l_6rjH82ihlfXbJ0LJgWXBLWpbQ0Kh-FAVVF9TEkFKkWa_RnTE-aQF6N65P-mJc78Y19LoYL7F3zxO26Uz2b-iP3wJ8vABU_vnoKOpkHHlD1kUyWdvg_j_hN4omlxk</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Torre Monmany, Nuria</creator><creator>Maya Gallego, Sara</creator><creator>Esclapés Giménez, Teresa</creator><creator>Sardà Sánchez, Marta</creator><creator>Rodríguez Losada, Olalla</creator><creator>Martínez Planas, Aina</creator><creator>Oller Fradera, Olga</creator><creator>Alarcón, Ana</creator><creator>Esteban, Elisabeth</creator><general>Elsevier España, S.L.U</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20211201</creationdate><title>Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia</title><author>Torre Monmany, Nuria ; Maya Gallego, Sara ; Esclapés Giménez, Teresa ; Sardà Sánchez, Marta ; Rodríguez Losada, Olalla ; Martínez Planas, Aina ; Oller Fradera, Olga ; Alarcón, Ana ; Esteban, Elisabeth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2535-9cb0bdebdd62416e9d622b9e2dcaba012784fecb855af60450d81ccbacdf025d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Asfixia neonatal</topic><topic>Asphyxia neonatorum</topic><topic>Encefalopatía hipoxico-isquémica</topic><topic>Hipotermia pasiva</topic><topic>Hipotermia servo-controlada</topic><topic>Hipotermia terapéutica</topic><topic>Hypoxic-ischemic encephalopathy</topic><topic>Neonatal transport</topic><topic>Passive cooling</topic><topic>Servo-controlled cooling</topic><topic>Therapeutic hypothermia</topic><topic>Transporte neonatal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Torre Monmany, Nuria</creatorcontrib><creatorcontrib>Maya Gallego, Sara</creatorcontrib><creatorcontrib>Esclapés Giménez, Teresa</creatorcontrib><creatorcontrib>Sardà Sánchez, Marta</creatorcontrib><creatorcontrib>Rodríguez Losada, Olalla</creatorcontrib><creatorcontrib>Martínez Planas, Aina</creatorcontrib><creatorcontrib>Oller Fradera, Olga</creatorcontrib><creatorcontrib>Alarcón, Ana</creatorcontrib><creatorcontrib>Esteban, Elisabeth</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anales de Pediatría</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Torre Monmany, Nuria</au><au>Maya Gallego, Sara</au><au>Esclapés Giménez, Teresa</au><au>Sardà Sánchez, Marta</au><au>Rodríguez Losada, Olalla</au><au>Martínez Planas, Aina</au><au>Oller Fradera, Olga</au><au>Alarcón, Ana</au><au>Esteban, Elisabeth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia</atitle><jtitle>Anales de Pediatría</jtitle><addtitle>An Pediatr (Engl Ed)</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>95</volume><issue>6</issue><spage>459</spage><epage>466</epage><pages>459-466</pages><issn>2341-2879</issn><eissn>2341-2879</eissn><abstract>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.
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.
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.
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.
La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR), requiriendo ser transportados.
Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019).
51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo.
La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR.</abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>34462230</pmid><doi>10.1016/j.anpede.2021.07.005</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Asfixia neonatal Asphyxia neonatorum Encefalopatía hipoxico-isquémica Hipotermia pasiva Hipotermia servo-controlada Hipotermia terapéutica Hypoxic-ischemic encephalopathy Neonatal transport Passive cooling Servo-controlled cooling Therapeutic hypothermia Transporte neonatal |
| title | Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia |
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