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Temperature control during therapeutic moderate whole-body hypothermia for neonatal encephalopathy
  1. B Strohm1,
  2. D Azzopardi2
  3. on behalf of the UK TOBY Cooling Register Study Group
  1. 1National Perinatal Epidemiology Unit, Old Road Campus, Headington, Oxford, UK
  2. 2Institute of Clinical Sciences, Hammersmith Hospital, Imperial College London, London, UK
  1. Correspondence to Dr Denis Azzopardi, Division of Clinical Sciences, Hammersmith Hospital, Imperial College London, Hammersmith Hospital, 5th Floor Ham House, DuCane Road, London W12 5HS, UK; d.azzopardi{at}imperial.ac.uk

Abstract

Introduction The precision of temperature control achieved in clinical practice during therapeutic hypothermia in neonates has not been described.

Methods The hourly rectal temperature recordings from 17 infants treated with servo controlled and an equal number treated with manually adjusted cooling equipment were examined. The target rectal temperature for all infants is 33.5°C for 72 h.

Results During 6 to 72 h after start of cooling, the mean (95% CI, variance) of the averaged rectal temperatures was 33.6°C (95% CI 33.4°C to 33.8°C, 0.1°C) in the manually adjusted group and 33.4°C (95% CI 33.3°C to 33.5°C, 0.04°C) in the servo controlled group (means, p=0.08; equality of variance, p=0.03). The variance was also significantly different between infant groups during 1 to 5 h after start of cooling, p=0.01, but not during rewarming.

Conclusion The rectal temperature can be maintained close to the target temperature with either manually adjusted or servo controlled equipment, but there is less temperature variability with the servo controlled system in use in the UK.

https://doi.org/10.1136/adc.2009.163816

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    Footnotes

    • The UK TOBY Cooling Register study group Dr Denis Azzopardi, Imperial College London; Professor Peter Brocklehurst, University of Oxford; Dr Andrew Currie, Leicester Royal Infirmary; Professor David Edwards, Imperial College London; Professor Henry Halliday, Queens University Belfast; Professor Malcolm Levene, University of Leeds; Dr Elia Maalouf, Homerton Hospital London; Professor Neil Marlow, University College London; Mr Edmund Juszczak, University of Oxford; Professor Marianne Thoresen, Bristol University; Professor Michael Weindling, Liverpool's Womens Hospital; Professor Andrew Whitelaw, Bristol University.

    • Funding This paper reports on an independent study which is part-funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the department. The UK TOBY Cooling Register is currently administered as part of the MRC funded TOBY Study (Whole body cooling as a treatment for perinatal asphyxial encephalopathy).

    • Competing interests None.

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