McLean Lucia, Dalrymple Hannah, Sasidharan Lekshmi, Grant Trish, Browning Carmo Kathryn
The Royal Women's Hospital, Parkville, Victoria, Australia.
Newborn and Paediatric Emergency Transport Service, Bankstown, New South Wales, Australia.
J Paediatr Child Health. 2025 Mar;61(3):411-416. doi: 10.1111/jpc.16758. Epub 2024 Dec 24.
To examine the efficacy of current non-servo-based cooling methods used by NETS NSW in treating hypoxic ischaemic encephalopathy (HIE) with therapeutic hypothermia (TH) in neonatal retrieval.
A retrospective observational study of infants treated with TH for HIE retrieved by NETS NSW from January 2017 to June 2020 inclusive. Primary outcomes were the proportion of neonates achieving TH within 6 h of life and maintaining temperature in a therapeutic range.
82 patients were included in analysis. Mean gestational age (GA) was 39 weeks (IQR 38-40) and mean birthweight (BW) 3297 g (SD 607 g). 68 infants (82.9%) were passively cooled while 14 (17.1%) were cooled with gel packs. 20 infants (21.4%) had rectal temperature monitoring before retrieval. 45 infants (55.6%) reached TH within 6 h of birth. Only 56 infants (68.3%) reached TH during retrieval. Of these infants, 45 (80.4%) had subsequent temperatures outside the therapeutic range.
Infants receiving TH through non-servo-controlled methods are commonly exposed to temperature instability and overcooling. Introduction of servo-controlled cooling devices is required to improve care and management of perinatal HIE in retrieval.
研究新南威尔士州新生儿紧急转运服务（NETS NSW）目前使用的非伺服式降温方法在新生儿转运中治疗缺氧缺血性脑病（HIE）并进行治疗性低温（TH）的疗效。
对2017年1月至2020年6月期间由NETS NSW转运并接受TH治疗的HIE婴儿进行回顾性观察研究。主要结局指标为新生儿在出生后6小时内达到TH并将体温维持在治疗范围内的比例。
82例患者纳入分析。平均胎龄（GA）为39周（四分位间距38 - 40周），平均出生体重（BW）为3297克（标准差607克）。68例婴儿（82.9%）采用被动降温，14例（17.1%）采用凝胶包降温。20例婴儿（21.4%）在转运前进行了直肠温度监测。45例婴儿（55.6%）在出生后6小时内达到TH。仅56例婴儿（68.3%）在转运期间达到TH。在这些婴儿中，45例（80.4%）随后体温超出治疗范围。
通过非伺服控制方法接受TH治疗的婴儿通常面临温度不稳定和过度降温的问题。需要引入伺服控制的降温设备，以改善围产期HIE转运中的护理和管理。
