Journal of Clinical Pediatrics and Neonatal Care

Cooling on Transport for Neonates with Hypoxic Ischemic Encephalopathy

Published on: 2019-01-08

Abstract

Background: Therapeutic hypothermia for neonates with Hypoxic Ischemic Encephalopathy (HIE) has been shown to reduce cerebral injury and disabilities. The cooling on transport can minimize delay in treatment. This paper is to study the feasibility and effect of the cooling on transport and therapeutic hypothermia for neonates with HIE.

Methods: The enrolled neonates with HIE were hospitalized in our hospital form July 2013 to June 2016 and divided into group A (Be admitted to hospital by cooling transfer, initiation of therapeutic hypothermia < 6 hr after birth), group B (Be admitted to hospital by cooling transfer, initiation of therapeutic hypothermia 6-12 hr after birth), group C (Born in our hospital, initiation of therapeutic hypothermia < 6 hr after birth) and the control group (without therapeutic hypothermia). The survival rate and neurodevelopment outcomes were analyzed in each group.

Results: The survival rate in group A (93%), in group B (90%), and in group C (88%) were higher than that in control group (63%). (All values of P < 0.05). The score of neonatal behavioral neurological assessment in group A (36.2 ± 1.7), in group B (90%) and in group C (88%) were higher than those in control group (63%). (All values of P < 0.05). The incidence rate of neurodevelopmental retardation, cerebral palsy and mental retardation in group A (25%, 19%, 19%), in group B (10%, 7%, 10%) and in group C (7%, 8%, 8%) were lower than those in control group (100%, 100%, 88%). (All values of P < 0.05). There was no statistically significant difference in those among group A, group B and group C. (All values of P > 0.05). Conclusions: Therapeutic hypothermia might be extended to peripheral hospitals through cooling on transport and start within the first 12 hr after birth. The cooling on transport and therapeutic hypothermia is a useful and safe treatment method for neonates with HIE.

Keywords

Neonate; Cooling On Transport; Therapeutic Hypothermia; Hypoxic Ischemic Encephalopathy