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Therapeutic hypothermia in mild neonatal encephalopathy: a national survey of practice in the UK
  1. Vânia Oliveira1,
  2. Dev Prya Singhvi1,
  3. Paolo Montaldo1,
  4. Peter J Lally1,
  5. Josephine Mendoza1,
  6. Swati Manerkar2,
  7. Seetha Shankaran3,
  8. Sudhin Thayyil1
  1. 1 Centre for Perinatal Neuroscience, Department of Paediatrics, Imperial College London, London, London, UK
  2. 2 Neonatal Unit, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
  3. 3 Department of Neonatal-Perinatal Medicine, Wayne State University, Detroit, Michigan, USA
  1. Correspondence to Vânia Oliveira, Centre for Perinatal Neuroscience, Imperial College London, London W12 0HS, UK; v.oliveira{at}imperial.ac.uk

Abstract

Although major cooling trials (and subsequent guidelines) excluded babies with mild encephalopathy, anecdotal evidence suggests that cooling is often offered to these infants. We report a national survey on current cooling practices for babies with mild encephalopathy in the UK. From 74 neonatal units contacted, 68 were cooling centres. We received 54 responses (79%) and included 48 (five excluded due to incomplete data and one found later not to offer cooling). Of these, 36 centres (75%) offered cooling to infants with mild encephalopathy. Although most of the participating units reported targeting 33–34°C core temperature, seven (19%) considered initiating cooling beyond 6 hours of age and 13 (36%) discontinued cooling prior to 72 hours. Babies were ventilated for cooling in two (6%) units and 13 (36%) sedated all cooled babies. Enteral feeding was withheld in 15 (42%) units and reduced below 25% of requirements in eight (22%) units. MRI and neurodevelopmental outcome evaluation were offered to all cooled babies in 29 (80%) and 27 (75%) units, respectively. Further research is necessary to ensure optimal neuroprotection in mild encephalopathy.

  • neonatal encephalopathy
  • therapeutic hypothermia

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Footnotes

  • Contributors VO and DPS conducted the survey, analysed the data and wrote the first draft of the manuscript. PM, PJL, JM, SM and SS assisted in the interpretation of the data and preparation of the manuscript. ST conceived the idea, supervised the project, interpreted the data and prepared the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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