Document Detail


A comparison of cooling methods used in therapeutic hypothermia for perinatal asphyxia.
MedLine Citation:
PMID:  20530071     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to compare cooling methods during therapeutic hypothermia (TH) for moderate or severe perinatal asphyxia with regard to temperature and hemodynamic stability. METHODS: A total of 73 newborns received TH in our center between 1999 and 2009 by 4 methods: (1) selective head cooling with mild systemic hypothermia by using cap (SHC; n = 20); (2) whole-body cooling with mattress manually controlled (WBCmc; n = 23); (3) whole-body cooling with body wrap servo-controlled (WBCsc; n = 28); and (4) whole-body cooling with water-filled gloves (n = 2). Target rectal temperatures (Trec) were 34.5 +/- 0.5 degrees C (SHC) and 33.5 +/- 0.5 degrees C (WBC). Trec, mean arterial blood pressure, and heart rate were collected from retrospective chart review. RESULTS: Groups had similar baseline characteristics and condition at birth. Trec was within target temperature +/-0.5 degree C for 97% of the time in infants with WBCsc, 81% in infants with WBCmc, 76% in infants with SHC, and 74% in infants who were cooled with gloves. Mean overshoot was 0.3 degree C for WBCsc, 1.3 degrees C for WBCmc, and 0.8 degree C for SHC groups. There was no difference in mean arterial blood pressure or mean heart between groups during the maintenance of cooling. In infants who were rewarmed at similar speed, there was greater variation in Trec in the SHC compared with the WBCsc group. CONCLUSIONS: Manually controlled cooling systems are associated with greater variability in Trec compared with servo-controlled systems. A manual mattress often causes initial overcooling. It is unknown whether large variation in temperature adversely affects the neuroprotection of TH.
Authors:
Nicholas Hoque; Ela Chakkarapani; Xun Liu; Marianne Thoresen
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-07
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e124-30     Citation Subset:  AIM; IM    
Affiliation:
Child Health, School of Clinical Sciences, University of Bristol, St Michael's Hospital, Bristol, Avon, UK.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Asphyxia Neonatorum / diagnosis*,  therapy*
Blood Pressure Determination
Body Temperature / physiology
Body Temperature Regulation
Cohort Studies
Female
Follow-Up Studies
Heart Rate / physiology
Humans
Hypothermia, Induced / instrumentation*,  methods*
Infant, Newborn
Male
Monitoring, Physiologic / methods
Probability
Retrospective Studies
Rewarming / methods
Risk Assessment
Severity of Illness Index
Thermography
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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