Sussman Craig B, Weiss Michael D
Department of Pediatrics, Division of Neonatology, University of Florida, Jacksonville (Dr Sussman); and Department of Pediatrics, Division of Neonatology, University of Florida, Gainesville (Dr Weiss).
Adv Neonatal Care. 2013 Dec;13(6):415-23; quiz 424-5. doi: 10.1097/ANC.0000000000000028.
Hypoxic-ischemic encephalopathy (HIE) occurring during the perinatal period is one of the primary causes of severe, long-term neurological deficits in children. Initial systemic supportive therapy remains a critical aspect of HIE management. In addition to support therapy, the widespread use of hypothermia has demonstrated a reduction in death and neurodevelopmental disability in infants with moderate to severe HIE. Neonates with HIE born outside of tertiary care centers must be rapidly identified as hypothermia candidates and have emergent transport arranged. While waiting for the transport team to arrive, these neonates often require intensive stabilization, including meticulous temperature management. This article examines the need for HIE outreach teaching programs, assists in the identification of a neonate for hypothermia therapy, and supplies evidence-based recommendations for the initial stabilization and care of neonates delivered at nontertiary care facilities. The guidelines and materials supplied represent the outreach model used by our regional hypothermia center and disseminated to the surrounding referral hospitals.
围生期发生的缺氧缺血性脑病（HIE）是儿童严重长期神经功能缺损的主要原因之一。初始的全身支持治疗仍然是HIE管理的关键环节。除了支持治疗外，低温疗法的广泛应用已证明可降低中重度HIE婴儿的死亡率和神经发育残疾率。在三级医疗中心以外出生的HIE新生儿必须迅速被确定为低温治疗的候选对象，并安排紧急转运。在等待转运团队到来的过程中，这些新生儿通常需要强化稳定治疗，包括精心的体温管理。本文探讨了HIE外展教学项目的必要性，协助确定适合低温治疗的新生儿，并为在非三级医疗机构分娩的新生儿的初始稳定治疗和护理提供循证建议。所提供的指南和材料代表了我们地区低温治疗中心所采用并传播到周边转诊医院的外展模式。
