Hagmann, CF;
Brotschi, B;
Bernet, V;
Latal, B;
Berger, TM;
Robertson, NJ;
(2011)
Hypothermia for perinatal asphyxial encephalopathy. A Swiss survey of opinion, practice and cerebral investigations.
Swiss Medical Weekly
, 141
, Article w13145. 10.4414/smw.2011.13145.
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Abstract
BACKGROUND: Perinatal asphyxial encephalopathy occurs in 1-per 1000 live births and is associated with high mortality and morbidity. Therapeutic hypothermia increases intact survival and improves neurodevelopmental outcome in survivors.AIMS: To evaluate (i) the opinion and practice of therapeutic hypothermia as a therapy for moderate to severe perinatal asphyxial encephalopathy amongst Swiss neonatologists and paediatric intensive care specialists, (ii) the current clinical management of infants with perinatal asphyxial encephalopathy and (iii) the need for a national perinatal asphyxia and therapeutic hypothermia registry.METHODS: Two web-based questionnaires were sent to 18 senior staff physicians within the Swiss Neonatal Network.RESULTS: Therapeutic hypothermia was considered effective by all responders, however only 11 of 18 units provided therapeutic hypothermia. Cooling was initiated during transfer and performed passively in 82% of centres with a target rectal temperature of 33-34 degrees C. Most units ventilated infants with perinatal asphyxial encephalopathy if clinically indicated and 73% of responders gave analgesia routinely to cooled infants. Neuromonitoring included continuous amplitude integrated EEG (aEEG) and EEG. Neuroimaging included cranial ultrasound (cUS), magnetic resonance imaging (MRI) and computed tomography (CT). Sixty-seven percent of units treating infants with perinatal asphyxial encephalopathy performed MRI routinely. All heads of departments questioned indicated that a "Swiss National Asphyxia and Cooling Registry" is needed.CONCLUSIONS: In Switzerland, access to therapeutic hypothermia is widespread and Swiss neonatologists believe that therapeutic hypothermia for perinatal asphyxia is effective. National cooling protocols are needed for the management of infants with perinatal asphyxial encephalopathy in order to ensure safe cooling, appropriate monitoring, imaging and follow-up assessment. A national registry is needed to collect data on diagnosis, treatment, adverse events and outcome.
| Type: | Article |
|---|---|
| Title: | Hypothermia for perinatal asphyxial encephalopathy. A Swiss survey of opinion, practice and cerebral investigations |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.4414/smw.2011.13145 |
| Publisher version: | http://dx.doi.org/10.4414/smw.2011.13145 |
| Language: | English |
| Additional information: | EMH Swiss Medical Publishers Ltd. grants to all users on the basis of the Creative Commons license "Attribution - Non commercial - No Derivative Works" for an unlimited period the right to copy, distribute, display, and perform the work as well as to make it publicly available on condition that: (1) the work is clearly attributed to the author or licensor (2) the work is not used for commercial purposes and (3) the work is not altered, transformed, or built upon. Any use of the work for commercial purposes needs the explicit prior authorisation of EMH on the basis of a written agreement. |
| Keywords: | neonatal encephalopathy, hypothermia, national registry, hypoxic-ischemic encephalopathy, resonance-imaging findings, whole-body hypothermia, neonatal encephalopathy, newborn encephalopathy, moderate hypothermia, birth asphyxia, therapeutic hypothermia, developmental outcomes, systemic hypothermia |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1334384 |
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