Population-Based Study of the National Implementation of Therapeutic Hypothermia in Infants with Hypoxic-Ischemic Encephalopathy
Por:
Arnaez J, García-Alix A, Arca G, Caserío S, Valverde E, Moral MT, Benavente-Fernández I and Lubián-López S
Publicada:
1 mar 2018
Ahead of Print:
11 ago 2017
Resumen:
Data on the incidence of hypoxic-ischemic encephalopathy (HIE) in the first 6 hours of life together with the implementation of therapeutic hypothermia (TH) are relevant to delineate actions to achieve the lowest rates of neonatal mortality, morbidity, and long-term impact on health associated with HIE. This is population-based national survey study, including newborns 35 weeks of gestation with moderate-to-severe HIE from all level III neonatal care units, to provide the incidence of HIE for the period 2012-2013, and the implementation of TH up to June 2015 in Spain. Incidence rate was 0.77 per 1000 live births (95% confidence interval 0.72-0.83). By June 2015, 63% (57/90) of the units had implemented TH; 95% of them performed servo-controlled whole-body TH. For the 2-year period, 86% of the newborns diagnosed with moderate-to-severe HIE received TH. Active TH increased in use from 78% in 2012 to 85% in 2013 (p=0.01). The main reasons for not cooling were a delay in the diagnosis (31/682) and the fact that the treatment was not offered (20/682). Interhospital patient transfer was performed using passive hypothermia, by appropriately trained personnel in 61% of centers. Eighteen percent of newborns with moderate or severe HIE died, without significant differences between the 2 years. Up-to-date knowledge of the national coverage of neonatal care of infants with HIE in developed countries is a prerequisite to reducing the load of HIE in this area and to facilitating coordinated, eliminate investigation.
Filiaciones:
Arnaez J:
1 Unidad de Neonatología, Hospital Universitario de Burgos , Burgos, España, Fundación NeNe, España
García-Alix A:
2 Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu , Universitat de Barcelona, Barcelona, España, Fundación NeNe, España
Arca G:
3 Unidad de Neonatología, Hospital Universitario Clinic (Sede Maternitat) , Barcelona, España, Fundación NeNe, España
Caserío S:
4 Unidad de Neonatología, Hospital Universitario Río Hortega , Valladolid, España, Fundación NeNe, España
Valverde E:
5 Servicio de Neonatología. Hospital Universitario La Paz , Madrid, España, Fundación NeNe, España
Moral MT:
6 Servicio de Neonatología, Hospital Universitario 12 de Octubre , Madrid, España, Fundación NeNe, España
Benavente-Fernández I:
7 Unidad de Neonatología, Hospital Universitario Puerta del Mar , Cádiz, España, Fundación NeNe, España
Lubián-López S:
7 Unidad de Neonatología, Hospital Universitario Puerta del Mar , Cádiz, España, Fundación NeNe, España
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