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Torre Monmany N, Maya Gallego S, Esclapés Giménez T, Sardà Sánchez M, Rodríguez Losada O, Martínez Planas A, Oller Fradera O, Alarcón A, Esteban E. Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia. An Pediatr (Barc) 2021; 95:459-466. [PMID: 34844879 DOI: 10.1016/j.anpede.2021.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. METHODS Prospective-observational study (April 18 2018 - November 19 2019). Newborns (≥34 weeks of gestational age (GA) and >1800 g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. RESULTS 51 newborns. The median stabilisation and transport time were 68 min (p25-75, 45-85 min) and 30 min (p25-75, 15-45 min), respectively. The mean age at arrival at the receiving unit was 4 h and 18 min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There were no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. CONCLUSIONS Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies.
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Affiliation(s)
- Nuria Torre Monmany
- Neonatal and Paediatric Transport Unit. Sant Joan de Déu Hospital, Esplugues de Llobregat. Spain; Neonatal unit, Parc Taulí Hospital, Sabadell, Spain; Aerial Paediatric and Neonatal Transport Unit, Parc Taulí Hospital, Sabadell, Spain.
| | - Sara Maya Gallego
- Neonatal and Paediatric Transport Unit. Sant Joan de Déu Hospital, Esplugues de Llobregat. Spain
| | - Teresa Esclapés Giménez
- Neonatal and Paediatric Transport Unit, Vall Hebrón Hospital, Barcelona, Spain; Neonatology Unit, Vall Hebrón Hospital, Barcelona, Spain
| | - Marta Sardà Sánchez
- Neonatal and Paediatric Transport Unit. Sant Joan de Déu Hospital, Esplugues de Llobregat. Spain; Neonatal unit, Parc Taulí Hospital, Sabadell, Spain; Aerial Paediatric and Neonatal Transport Unit, Parc Taulí Hospital, Sabadell, Spain
| | | | - Aina Martínez Planas
- Neonatal and Paediatric Transport Unit. Sant Joan de Déu Hospital, Esplugues de Llobregat. Spain; Paediatric hospitalization unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Olga Oller Fradera
- Neonatal and Paediatric Transport Unit, Vall Hebrón Hospital, Barcelona, Spain; Paediatric Intensive Care Unit, Vall Hebrón Hospital, Barcelona, Spain
| | - Ana Alarcón
- Neonatology Unit, Sant Joan de Déu Hospital, Esplugues de Llobregat, Spain; Sant Joan de Déu research unit, Barcelona university, Esplugues de Llobregat, Spain
| | - Elisabeth Esteban
- Neonatal and Paediatric Transport Unit. Sant Joan de Déu Hospital, Esplugues de Llobregat. Spain; Paediatric Intensive Care Unit, Sant Joan de Déu Hospital, Esplugues de Llobregat, Spain
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Torre Monmany N, Maya Gallego S, Esclapés Giménez T, Sardà Sánchez M, Rodríguez Losada O, Martínez Planas A, Oller Fradera O, Alarcón A, Esteban E. [Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia]. An Pediatr (Barc) 2021; 95:S1695-4033(21)00243-5. [PMID: 34462230 DOI: 10.1016/j.anpedi.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/05/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. METHODS Prospective-observational study (April 18-November 19). Newborns (≥34 weeks of gestational age (GA) and >1800g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. RESULTS 51 newborns. The median stabilisation and transport time were 68min (p25-75, 45-85min) and 30min (p25-75, 15-45min), respectively. The mean age at arrival at the receiving unit was 4h and 18min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There was no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. CONCLUSIONS Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies.
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Affiliation(s)
- Nuria Torre Monmany
- Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España; Unidad de Neonatología, Hospital Parc Taulí, Sabadell, España; Unidad de Transporte Aéreo Pediátrico y Neonatal, Hospital Parc Taulí, Sabadell, España.
| | - Sara Maya Gallego
- Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España
| | - Teresa Esclapés Giménez
- Unidad de Transporte Pediátrico y Neonatal, Hospital Vall d'Hebrón, Barcelona, España; Unidad de Neonatología, Hospital Vall d'Hebrón, Barcelona, España
| | - Marta Sardà Sánchez
- Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España; Unidad de Neonatología, Hospital Parc Taulí, Sabadell, España; Unidad de Transporte Aéreo Pediátrico y Neonatal, Hospital Parc Taulí, Sabadell, España
| | | | - Aina Martínez Planas
- Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España; Unidad de Hospitalización de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona. España
| | - Olga Oller Fradera
- Unidad de Transporte Pediátrico y Neonatal, Hospital Vall d'Hebrón, Barcelona, España; Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Vall d'Hebrón, Barcelona, España
| | - Ana Alarcón
- Unidad de Neonatología, Hospital Sant Joan de Déu, Esplugues de Llobregat, España; Institut de Recerca de Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, España
| | - Elisabeth Esteban
- Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España; Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Esplugues de Llobregat, España
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