Efficacy of Therapeutic Hypothermia During Transport of Newborns With Perinatal Hypoxic-Ischaemic Encephalopathy: Experience From Newborn and Paediatric Transport Service, New South Wales

Lucia McLean; Hannah Dalrymple; Lekshmi Sasidharan; Trish Grant; Kathryn Browning Carmo

doi:10.1111/jpc.16758

Efficacy of Therapeutic Hypothermia During Transport of Newborns With Perinatal Hypoxic-Ischaemic Encephalopathy: Experience From Newborn and Paediatric Transport Service, New South Wales

J Paediatr Child Health. 2024 Dec 24. doi: 10.1111/jpc.16758. Online ahead of print.

Authors

Lucia McLean^{1

2}, Hannah Dalrymple^{2

3

4}, Lekshmi Sasidharan², Trish Grant², Kathryn Browning Carmo^{2

3

4}

Affiliations

¹ The Royal Women's Hospital, Parkville, Victoria, Australia.
² Newborn and Paediatric Emergency Transport Service, Bankstown, New South Wales, Australia.
³ Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
⁴ Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.

PMID: 39719301
DOI: 10.1111/jpc.16758

Abstract

Aim: To examine the efficacy of current non-servo-based cooling methods used by NETS NSW in treating hypoxic ischaemic encephalopathy (HIE) with therapeutic hypothermia (TH) in neonatal retrieval.

Methods: A retrospective observational study of infants treated with TH for HIE retrieved by NETS NSW from January 2017 to June 2020 inclusive. Primary outcomes were the proportion of neonates achieving TH within 6 h of life and maintaining temperature in a therapeutic range.

Results: 82 patients were included in analysis. Mean gestational age (GA) was 39 weeks (IQR 38-40) and mean birthweight (BW) 3297 g (SD 607 g). 68 infants (82.9%) were passively cooled while 14 (17.1%) were cooled with gel packs. 20 infants (21.4%) had rectal temperature monitoring before retrieval. 45 infants (55.6%) reached TH within 6 h of birth. Only 56 infants (68.3%) reached TH during retrieval. Of these infants, 45 (80.4%) had subsequent temperatures outside the therapeutic range.

Conclusions: Infants receiving TH through non-servo-controlled methods are commonly exposed to temperature instability and overcooling. Introduction of servo-controlled cooling devices is required to improve care and management of perinatal HIE in retrieval.

Keywords: hypoxic‐ischaemic encephalopathy; neonatal transport; neonatology; therapeutic hypothermia.