Therapeutic hypothermia in mild neonatal encephalopathy: a national survey of practice in the UK. Issue 4 (23rd September 2017)

• Record Type: Journal Article
• Authors: Oliveira, Vânia; Singhvi, Dev Prya; Montaldo, Paolo; Lally, Peter J; Mendoza, Josephine; Manerkar, Swati; Shankaran, Seetha; Thayyil, Sudhin
• Is Part Of: Archives of disease in childhood. Volume 103:Issue 4(2018)
• Page Start: F388
• Page End: F390
• Publication Date: 2017-09-23
• Subjects: neonatal encephalopathy -- therapeutic hypothermia; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2017-313320
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Although major cooling trials (and subsequent guidelines) excluded babies with mild encephalopathy, anecdotal evidence suggests that cooling is often offered to these infants. We report a national survey on current cooling practices for babies with mild encephalopathy in the UK. From 74 neonatal units contacted, 68 were cooling centres. We received 54 responses (79%) and included 48 (five excluded due to incomplete data and one found later not to offer cooling). Of these, 36 centres (75%) offered cooling to infants with mild encephalopathy. Although most of the participating units reported targeting 33–34°C core temperature, seven (19%) considered initiating cooling beyond 6 hours of age and 13 (36%) discontinued cooling prior to 72 hours. Babies were ventilated for cooling in two (6%) units and 13 (36%) sedated all cooled babies. Enteral feeding was withheld in 15 (42%) units and reduced below 25% of requirements in eight (22%) units. MRI and neurodevelopmental outcome evaluation were offered to all cooled babies in 29 (80%) and 27 (75%) units, respectively. Further research is necessary to ensure optimal neuroprotection in mild encephalopathy.