新生儿转运中的治疗性低温。
Therapeutic hypothermia during neonatal transport.
机构信息
Neonatal Unit, St Michael's Hospital, Bristol, UK.
出版信息
Acta Paediatr. 2011 Aug;100(8):1084-6; discussion e49. doi: 10.1111/j.1651-2227.2011.02249.x. Epub 2011 Apr 8.
AIM
To compare the effectiveness of different cooling methods used during neonatal transport in maintaining target temperature.
METHODS
Retrospective review of transport data for all infants centralized for therapeutic hypothermia between April 2008 and October 2009.
RESULTS
A total of 46 infants were retrieved for therapeutic hypothermia during the study period. During transport, 10 infants were passively cooled, 17 infants were actively cooled with adjuncts and 19 infants were actively cooled with a purpose-built cooling machine. On arrival at the tertiary unit, 84% of infants who were actively cooled with a purpose-built cooling machine had temperatures within the therapeutic range compared with 47% of infants who were actively cooled with adjuncts and 20% of infants who were passively cooled.
CONCLUSION
Passive cooling and cooling with adjuncts often fail to achieve temperatures within the desired therapeutic range. Therapeutic hypothermia during transport can be reliably achieved using a purpose-built cooling machine. We recommend that cooling during transport should only be undertaken using a purpose-built cooling machine.
目的
比较新生儿转运过程中使用不同冷却方法维持目标温度的效果。
方法
回顾性分析 2008 年 4 月至 2009 年 10 月期间所有集中进行治疗性低温治疗的转运婴儿的数据。
结果
研究期间共检索到 46 例接受治疗性低温治疗的婴儿。在转运过程中，10 例婴儿采用被动冷却，17 例婴儿采用辅助主动冷却，19 例婴儿采用定制冷却机主动冷却。到达三级单位时，采用定制冷却机主动冷却的婴儿中，84%的婴儿体温处于治疗范围内，而采用辅助主动冷却的婴儿中，有 47%的婴儿体温处于治疗范围内，采用被动冷却的婴儿中，有 20%的婴儿体温处于治疗范围内。
结论
被动冷却和辅助主动冷却往往无法达到所需的治疗温度范围。使用定制冷却机可以可靠地实现转运过程中的治疗性低温。我们建议，只有使用定制冷却机才能进行转运过程中的冷却。
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