Timing of Therapeutic Hypothermia for Inborn and Outborn Infants with Neonatal Encephalopathy

L Reaney; V Livingstone; C Bogue; E M Dempsey; P M Filan

Timing of Therapeutic Hypothermia for Inborn and Outborn Infants with Neonatal Encephalopathy

Ir Med J. 2016 Mar 10;109(3):369.

Authors

L Reaney¹, V Livingstone², C Bogue³, E M Dempsey⁴, P M Filan⁴

Affiliations

¹ University College Cork, Cork.
² INFANT Centre, Cork University Hospital, Cork.
³ Department of Radiology, Cork University Hospital, Cork.
⁴ Department of Neonatology, Cork University Maternity Hospital, Cork.

PMID: 27685816

Abstract

Therapeutic hypothermia is now the standard of care for infants with moderate to severe hypoxic ischaemic encephalopathy. Sixty-three infants received therapeutic hypothermia at Cork University Maternity Hospital (CUMH) from 2010-2014. Median gestational age was 40 weeks. Eighteen (29%) infants were Sarnat grade 3, 41(65%) grade 2 and 4(6%) grade 1. Nineteen outborn infants arrived in CUMH at a median (IQR) age of 310 (270, 420) minutes. Four (21%) outborn infants were within the target temperature range on arrival. Median (IQR) time (minutes) from birth to achieve target temperature was 136 (90, 195) for inborn and 300 (240, 360) for outborn infants (p < .01). Overall, 35 (56%) infants had electrical seizures, 42 (74%) had a normal MRI at a median (IQR) age of 7(6,9) days and the median(IQR) length of stay was 9 (7,11) days. Although no difference in seizures or MRI findings was seen, passive cooling does not achieve consistent temperature control for outborn infants.