远程新生儿学对需要治疗性低温的出生后新生儿缺氧缺血性脑病达到目标体温时间的影响。
Impact of teleneonatology on time to goal temperature in outborn neonates with hypoxic-ischemic encephalopathy requiring therapeutic hypothermia.
作者信息
Kaczor Mark, Hentz Roland, Youssef Paul E, Fine Anthony, Fang Jennifer
机构信息
Mayo Clinic, Division of Neonatal Medicine, Rochester, MN, USA.
Mayo Clinic, Division of Clinical Trials and Biostatistics, Rochester, MN, USA.
出版信息
J Perinatol. 2025 May 29. doi: 10.1038/s41372-025-02324-y.
OBJECTIVE
We assessed whether teleneonatology reduces time to goal temperature and early neurologic morbidity or mortality in outborn neonates with hypoxic-ischemic encephalopathy (HIE) that required therapeutic hypothermia (TH).
STUDY DESIGN
This retrospective observational study included outborn neonates with HIE treated with TH. The exposure was teleneonatology consultation. The primary outcome was time from birth to goal temperature (33-34 °C). The secondary outcome was a composite of early neurologic morbidity and in-hospital mortality.
RESULTS
Of the 77 neonates included in the study, 42 (55%) received teleneonatology consultations. Teleneonatology reduced time to goal temperature (mean ratio 0.76 [95% CI, 0.58, 0.99]). This was partially mediated by earlier transport team activation and more frequent initiation of passive cooling prior to transport team arrival. There was no difference in early neurologic morbidity or mortality.
CONCLUSIONS
Teleneonatology reduced time to goal temperature in outborn neonates with HIE requiring TH by expediting key steps in care processes.
目的
我们评估了远程新生儿学是否能缩短达到目标体温的时间，以及降低需要治疗性低温（TH）的出生后新生儿缺氧缺血性脑病（HIE）的早期神经疾病发病率或死亡率。
研究设计
这项回顾性观察性研究纳入了接受TH治疗的出生后HIE新生儿。暴露因素为远程新生儿学会诊。主要结局是从出生到目标体温（33 - 34°C）的时间。次要结局是早期神经疾病发病率和院内死亡率的综合指标。
结果
在纳入研究的77例新生儿中，42例（55%）接受了远程新生儿学会诊。远程新生儿学缩短了达到目标体温的时间（平均比值0.76 [95% CI，0.58，0.99]）。这部分是由于转运团队更早启动以及在转运团队到达之前更频繁地开始被动降温所致。早期神经疾病发病率或死亡率没有差异。
结论
远程新生儿学通过加快护理过程中的关键步骤，缩短了需要TH的出生后HIE新生儿达到目标体温的时间。
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