Wusthoff C J, Clark C L, Glass H C, Shimotake T K, Schulman J, Bonifacio S L
Division of Child Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.
Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
J Perinatol. 2018 Jan;38(1):54-58. doi: 10.1038/jp.2017.153. Epub 2017 Oct 19.
Although hospitals increasingly offer therapeutic hypothermia (TH), there is variable implementation of related services. We assessed current practices and opinions regarding what services should be required of centers providing TH in California.
We surveyed neonatal intensive care unit physicians statewide regarding practices and opinions about services related to TH.
Of the 50 participating centers (47% response rate), 66% offer TH. Most TH centers reported using: an evidence-based protocol (92%), neurology consultation (92%), amplitude-integrated electroencephalography (aEEG) or EEG (88%), magnetic resonance imagings (MRIs) interpreted by pediatric neuroradiologists (71%) and developmental follow-up (93%). TH centers reported treating a median of 11 patients annually (interquartile range (IQR) 4 to 24). Respondents considered it 'critical' that TH centers offer: aEEG monitoring (70%), MRI (69%), occupational and physical therapy (67%) and developmental follow-up (94%). Over 70% thought TH centers should treat a minimum volume annually (median=10, IQR 5 to 12).
Physicians across practice settings in California endorsed minimum standards for TH centers to promote quality of care.
尽管医院越来越多地提供治疗性低温（TH），但相关服务的实施情况各不相同。我们评估了加利福尼亚州提供TH的中心应提供哪些服务的当前做法和意见。
我们对全州新生儿重症监护病房的医生进行了调查，了解他们对与TH相关服务的做法和意见。
在50个参与中心（回复率47%）中，66%提供TH。大多数TH中心报告使用：循证方案（92%）、神经科会诊（92%）、振幅整合脑电图（aEEG）或脑电图（88%）、由儿科神经放射科医生解读的磁共振成像（MRI）（71%）以及发育随访（93%）。TH中心报告每年治疗的患者中位数为11例（四分位间距（IQR）4至24）。受访者认为TH中心提供以下服务“至关重要”：aEEG监测（70%）、MRI（69%）、职业和物理治疗（67%）以及发育随访（94%）。超过70%的人认为TH中心每年应治疗的患者数量至少为一定量（中位数=10，IQR 5至12）。
加利福尼亚州不同医疗机构的医生认可TH中心的最低标准，以提高医疗质量。
