Kapetanakis Andrew, Azzopardi Denis, Wyatt John, Robertson Nicola J
Neonatology, EGA UCL Institute for Women's Health, University College London, London, UK.
Acta Paediatr. 2009 Apr;98(4):631-5. doi: 10.1111/j.1651-2227.2008.01159.x. Epub 2008 Dec 10.
The 2007 Cochrane review of therapeutic hypothermia for neonatal encephalopathy (NE) indicates a significant reduction in adverse outcome. UK National Institute for Clinical Excellence guidelines are awaited.
To benchmark current opinion and practice to inform future strategies for optimal knowledge transfer for therapeutic hypothermia.
A web based questionnaire (30 sections related to opinion and practice of management of NE) sent to the clinical leads of Level I, II and III neonatal units throughout the UK in November/December 2007.
One hundred and twenty-five (out of 195) UK neonatal units responded (response rate 66%). Ten percent, 37.5% and 51.5% responses were from level I, II and III units respectively. Twenty eight percent of all units provided therapeutic hypothermia locally (52% of level III units), however 80% of responders would offer therapeutic hypothermia if there was the facility. Overall, 57% of responders considered therapeutic hypothermia effective or very effective - similar for all unit levels; 43% considered more data are required. Regional availability of therapeutic hypothermia exists in 55% of units and 41% of units offer transfer to a regional centre for therapeutic hypothermia.
In the UK in 2007, access to therapeutic hypothermia was widespread although not universal. More than half of responders considered therapeutic hypothermia effective. Fifty-five percent of perinatal networks have the facility to offer therapeutic hypothermia. The involvement of national bodies may be necessary to ensure the adoption of therapeutic hypothermia according to defined protocols and standards; registration is important and will help ensure universal neurodevelopmental follow up.
2007年Cochrane关于新生儿脑病（NE）治疗性低温的综述表明不良结局显著减少。英国国家临床优化研究所的指南尚在等待中。
对当前的观点和实践进行基准评估，为治疗性低温最佳知识转移的未来策略提供信息。
2007年11月/12月向英国各地一级、二级和三级新生儿病房的临床负责人发送了一份基于网络的调查问卷（30个与NE管理的观点和实践相关的部分）。
195家英国新生儿病房中有125家做出了回应（回应率66%）。分别有10%、37.5%和51.5%的回应来自一级、二级和三级病房。所有病房中有28%在当地提供治疗性低温（三级病房的这一比例为52%），然而80%的受访者表示如果有设施会提供治疗性低温。总体而言，57%的受访者认为治疗性低温有效或非常有效——各病房级别情况类似；43%的受访者认为需要更多数据。55%的病房有治疗性低温的区域可用性，41%的病房会将患者转至区域中心进行治疗性低温。
2007年在英国，治疗性低温的可及性广泛但不普遍。超过一半的受访者认为治疗性低温有效。55%的围产期网络有提供治疗性低温的设施。可能需要国家机构的参与，以确保按照既定方案和标准采用治疗性低温；登记很重要，将有助于确保全面的神经发育随访。
