新生儿脑病全身降温治疗在转运过程中的安全性和有效性
Safety and Effectiveness of Whole Body Cooling Therapy for Neonatal Encephalopathy on Transport.
作者信息
McNellis Emily, Fisher Tyler, Kilbride Howard W
机构信息
Department of Pediatrics, Division of Neonatology, The Children-s Mercy Hospitals and Clinics and the University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Graduate Medical Education, The Children-s Mercy Hospitals and Clinics and the University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
出版信息
Air Med J. 2015 Jul-Aug;34(4):199-206. doi: 10.1016/j.amj.2015.03.002.
OBJECTIVE
The purpose of this study was to evaluate the safety and effectiveness of a transport protocol using active and passive methods for therapeutic whole body cooling of the neonate with hypoxic-ischemic encephalopathy.
METHODS
A retrospective study of neonates who received whole body cooling during transport by our pediatric/neonatal transport team between December 2008 and April 2012 was conducted.
RESULTS
Sixty-three of 66 (95%) neonates arrived within a safety temperature range of 33.0°C-37°C, and 3 (5%) were hypothermic (31.9°C-32.8°C). No clinical complications of cooling during transport were identified. Twenty-five (38%) and 57(86%) achieved therapeutic cooling upon admission and ≤ 6 hours after birth, respectively. Factors associated with cooling > 6 hours included a later time of initial referral (2.44 vs. 1.07 hours, P = .01), a later rendezvous time (4.17 vs. 1.92 hours, P = .002), and a later admission time (6.46 vs. 3.99 hours, P = .001).
CONCLUSION
Whole body cooling of neonates with hypoxic-ischemic encephalopathy can be effectively and safely performed during interfacility transport.
目的
本研究旨在评估采用主动和被动方法对缺氧缺血性脑病新生儿进行治疗性全身降温的转运方案的安全性和有效性。
方法
对2008年12月至2012年4月期间由我们的儿科/新生儿转运团队在转运过程中接受全身降温的新生儿进行回顾性研究。
结果
66例新生儿中有63例（95%）在33.0°C - 37°C的安全温度范围内到达，3例（5%）体温过低（31.9°C - 32.8°C）。未发现转运过程中降温的临床并发症。分别有25例（38%）和57例（86%）在入院时和出生后≤6小时达到治疗性降温。与降温超过6小时相关的因素包括初始转诊时间较晚（2.44小时对1.07小时，P = 0.01）、会合时间较晚（4.17小时对1.92小时，P = 0.002）和入院时间较晚（6.46小时对3.99小时，P = 0.001）。
结论
缺氧缺血性脑病新生儿的全身降温可在机构间转运期间有效且安全地进行。
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