Abstract:
The purpose of this paper is to compare the achievement of target temperature and the short-term neurological outcome according to the use of servo-controlled hypothermia in transport. This is a monocentric retrospective observational before-and-after uncontrolled study of newborns transported for neonatal encephalopathy. The first group was transported from 01/01/2019 to 12/31/2019 in passive hypothermia and the second group from 01/01/2021 to 12/31/2021 in controlled hypothermia. We included patients who had a total of 72 h of servo-controlled therapeutic hypothermia (CTH). We excluded those who had no or less than 72 h of CTH. There were 33 children transported in passive hypothermia in 2019 and 23 children transported in CTH in 2021. There were 9/28 (32%) patients in 2019 who reached the target temperature on arrival at the NICU compared with 20/20 (100%) in 2021 (p value < 0.01). There was a trend towards earlier age of therapeutic hypothermia if started in transport: 3.1 h ± 1.0 vs 4.0 h ± 2.4 for passive hypothermia (p value 0.07). There was no difference in age of arrival in NICU (4.0 h ± 1.2 with CTH vs 3.8 h ± 2.2 without CTH). We found no difference in short-term outcome (survival, abnormal MRI, seizures on EEG) between the two groups.
CONCLUSIONS: The use of servo-controlled therapeutic hypothermia makes it possible to reach the temperature target, without increasing the age of arrival in the NICU.
BACKGROUND: • CTH is rarely used during transport in France even if passive hypothermia rarely reaches temperature target, inducing overcooling and hyperthermia.
BACKGROUND: • This study shows better temperature control on arrival in the NICU with CTH compared to passive hypothermia, with no increase in arrival time.
摘要:
本文的目的是根据在运输中使用伺服控制的低温来比较目标温度的实现和短期的神经系统预后。这是一项单中心回顾性观察前后的研究,研究了因新生儿脑病而运输的新生儿。第一组在被动低温中从2019年01月01日至2019年12月31日转移,第二组在受控低温中从2021年01月01日至2021年12月31日转移。我们纳入了总共72小时伺服控制治疗性低温(CTH)的患者。我们排除了那些没有或少于72小时CTH的人。2019年有33名儿童在被动低温中运输,2021年有23名儿童在CTH中运输。2019年有9/28(32%)的患者在到达NICU时达到目标温度,而2021年为20/20(100%)(p值<0.01)。如果从运输开始,则有治疗性低温的趋势:3.1h±1.0vs被动低温的4.0h±2.4(p值0.07)。到达NICU的年龄没有差异(CTH为4.0h±1.2,无CTH为3.8h±2.2)。我们发现短期结果没有差异(生存率,MRI异常,两组之间的脑电图癫痫发作)。
结论:使用伺服控制治疗性低温可以达到温度目标,而不增加到达NICU的年龄。
背景:•在法国的运输过程中很少使用CTH,即使被动低温很少达到温度目标,引起过冷和过热。
背景:•这项研究表明,与被动低温相比,使用CTH到达NICU时的温度控制更好,没有增加到达时间。