TY - JOUR T1 - Highlights from this issue JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - 1 LP - 1 DO - 10.1136/archdischild-2021-323620 VL - 107 IS - 1 AU - Ben J Stenson Y1 - 2022/01/01 UR - http://fn.bmj.com/content/107/1/1.abstract N2 - Using the National Neonatal Research Database, Lara Shipley and colleagues studied infants≥36 weeks gestation who were admitted to UK neonatal units with moderate or severe hypoxic ischaemic encephalopathy (HIE). Between 2011 and 2016 there were 5059 infants. Birth in a centre which provided servo controlled therapeutic hypothermia (a cooling centre) vs a non-cooling centre was associated with increased survival to discharge without seizures (35.1% vs 31.8%; OR 1.15, 95% CI 1.02 to 1.31; p=0.02). Fewer infants born in cooling centres were diagnosed with seizures (60.7% vs 64.6%). Survival was similar. There were 2364 infants who were born in a non-cooling centre. Non-cooling centres would initiate passive cooling pending transfer of the infant to a cooling centre. Amongst the 2027 of these infants with a recorded admission temperature at the time of arrival at the cooling centre, 259 (12.7%) had a temperature in the recommended therapeutic range before 6 hours of age. There were a further 48.3% who arrived at the cooling centre between 6 and 12 hours of age with a temperature in the recommended range. The authors conclude that almost half of all infants with a diagnosis of moderate or severe HIE are born in non-cooling centres and the disparity of access to immediate therapeutic hypothermia could impact on outcomes. They encourage further equipping, training and support of non-cooling centres to minimise delays … ER -