Abstract
Background: Worldwide, a significant proportion of infants needing therapeutic hypothermia for hypoxia-ischaemia are transported to a higher-level facility for neonatal intensive care. They pose technical challenges to transport teams in cooling them. Concerns exist about the efficacy of passive cooling in neonatal transport to achieve a neurotherapeutic temprature. Servo-controlled cooling in the standard of care on the neonatal unit. The key question is whether the same standard of care in the neonatal unit can be safely used for therapeutic hypothermia during transport of neonates with suspected hypoxia-ischaemia.Methods: A prospective cross-sectional survey of United Kingdom (UK) neonatal transport services (n=21) was performed annually from 2011-2014 with a 100% response. The survey ascertained information about service provision and the method of cooling used during transport.Results: In 2011, all UK neonatal transport services provided therapeutic hypothermia during transport. Servo-control cooling machines were used by only 6 of the 21 teams (30%) while passive cooling was used by 15 of the 21 (70%) teams. In 2012 9 of the 21 teams (43%) were using servo-control. By 2014 the number of teams using servo-control cooling had more than doubled to 15 of the 21 (62%) services. Teams have done this through modification of transport trolleys and dedicated ambulances.Conclusion: Servo-controlled cooling in neonatal transport is becoming more common in the UK. The question remains whether it should be endorsed as a standard of care. Some teams continue to passively cool neonates with hypoxia-ischaemia during transport. This article reviews the drivers, current evidence, safety and processes involved in provision of therapeutic hypothermia during neonatal transport to enable teams to decide what would be the right option for them.
Highlights
Events in the perinatal period severe enough to cause neonatal hypoxic-ischemic encephalopathy (HIE) occur in 3 per 1000 births in the United Kingdom (UK) [1]
Longitudinal follow-up was performed through telephone survey for all transport services in December 2012, 2013, and 2014, as a significant proportion of services were moving from passive cooling to servo-controlled cooling in neonatal transport
Responses were received from all the neonatal transport services across the UK
Summary
Events in the perinatal period severe enough to cause neonatal hypoxic-ischemic encephalopathy (HIE) occur in 3 per 1000 births in the UK [1]. The British Association of Perinatal Medicine recommends the transfer of such neonates to centres with experience of providing therapeutic hypothermia. A significant proportion of infants benefiting from therapeutic hypothermia is born outside centres equipped to provide it. In a study conducted by Kendall, et al, 39 neonates were referred to the London neonatal transport service from 18 hospitals for transfer to one of eight specialist cooling centres over a nine-month period [5]. A significant proportion of infants needing therapeutic hypothermia for hypoxiaischaemia are transported to a higher-level facility for neonatal intensive care. They pose technical challenges to transport teams in cooling them. The key question is whether the same standard of care in the neonatal unit can be safely used for therapeutic hypothermia during transport of neonates with suspected hypoxia-ischaemia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
