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The impact of a register on the management of neonatal cooling in Switzerland
- Source :
- Early Human Development, Vol. 91, No 4 (2015) pp. 277-284
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- BACKGROUND Therapeutic hypothermia following hypoxic ischaemic encephalopathy in term infants was introduced into Switzerland in 2005. Initial documentation of perinatal and resuscitation details was poor and neuromonitoring insufficient. In 2011, a National Asphyxia and Cooling Register was introduced. AIMS To compare management of cooled infants before and after introduction of the register concerning documentation, neuromonitoring, cooling methods and evaluation of temperature variability between cooling methods. STUDY DESIGN Data of cooled infants before the register was in place (first time period: 2005-2010) and afterwards (second time period: 2011-2012) was collected with a case report form. RESULTS 150 infants were cooled during the first time period and 97 during the second time period. Most infants were cooled passively or passively with gel packs during both time periods (82% in 2005-2010 vs 70% in 2011-2012), however more infants were cooled actively during the second time period (18% versus 30%). Overall there was a significant reduction in temperature variability (p < 0.001) comparing the two time periods. A significantly higher proportion of temperature measurements within target temperature range (72% versus 77%, p < 0.001), fewer temperature measurements above (24% versus 7%, p < 0.001) and more temperatures below target range (4% versus 16%, p < 0.001) were recorded during the second time period. Neuromonitoring improved after introduction of the cooling register. CONCLUSION Management of infants with HIE improved since introducing the register. Temperature variability was reduced, more temperature measurements in the target range and fewer temperature measurements above target range were observed. Neuromonitoring has improved, however imaging should be performed more often.
- Subjects :
- Male
Resuscitation
610 Medicine & health
Hypoxic ischaemic encephalopathy
Hypothermia, Induced
Interquartile range
Humans
Medicine
2735 Pediatrics, Perinatology and Child Health
Case report form
Asphyxia
ddc:618
business.industry
Infant, Newborn
Records
Obstetrics and Gynecology
2729 Obstetrics and Gynecology
10027 Clinic for Neonatology
medicine.disease
Confidence interval
Register (music)
10036 Medical Clinic
Anesthesia
Hypoxia-Ischemia, Brain
Pediatrics, Perinatology and Child Health
Necrotizing enterocolitis
Female
10029 Clinic and Policlinic for Internal Medicine
medicine.symptom
business
Switzerland
Subjects
Details
- ISSN :
- 03783782
- Volume :
- 91
- Database :
- OpenAIRE
- Journal :
- Early Human Development
- Accession number :
- edsair.doi.dedup.....1379959d2ccdceb0f1613db8e00a4e0a