Impact of outreach education program on outcomes of neonates with hypoxic ischemic encephalopathy.

Autor:	Mohammad K; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Dharel D; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Abou Mehrem A; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Esser MJ; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Paul R; Foothills Medical Centre, Alberta Health Services, Calgary, Alberta., Zein H; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Scott JN; Department of Radiology, University of Calgary, Calgary, Alberta.; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta., Fiedrich E; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Murthy P; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Dossani S; Foothills Medical Centre, Alberta Health Services, Calgary, Alberta., Kopores K; Foothills Medical Centre, Alberta Health Services, Calgary, Alberta., Kowal D; Foothills Medical Centre, Alberta Health Services, Calgary, Alberta., Montpetit J; Foothills Medical Centre, Alberta Health Services, Calgary, Alberta., Al Awad E; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta., Thomas S; Department of Pediatrics, University of Calgary, Cumming School of Medicine, Calgary, Alberta.
Jazyk:	angličtina
Zdroj:	Paediatrics & child health [Paediatr Child Health] 2020 Jul 22; Vol. 26 (5), pp. e215-e221. Date of Electronic Publication: 2020 Jul 22 (Print Publication: 2021).
DOI:	10.1093/pch/pxaa075
Abstrakt:	Aim: To evaluate the impact of outreach education targeting neuroprotection on outcomes of outborn infants with moderate-to-severe hypoxic ischemic encephalopathy (HIE). Methods: A retrospective cohort study of infants admitted with moderate-to-severe HIE was conducted following the implementation of outreach education in January 2016. Key interventions were early identification and referral of infants with encephalopathy utilizing telemedicine and a centralized communication system, hands-on simulation, and interactive case discussion and dissemination of clinical management guidelines and educational resources. The association between the intervention and a composite outcome of death and/or severe brain injury on brain magnetic resonance imaging (MRI) was tested controlling for the confounding factors. Results: Of 165 neonates, 37 (22.4%) died and/or had a severe brain injury. This outcome decreased from 35% (27/77) to 11% (10/88) following the implementation of outreach education (P<0.001). Eligible infants not undergoing therapeutic hypothermia within 6 hours from birth decreased from 19.5% (15/77) to 4.5% (4/88). The use of inotropes decreased from 49.3% (38/77) to 19.6% (13/88). Any core temperature below 33°C was recorded for 20/53 (38%) before and 16/78 (21%) after, while those within the target range of 33°C to 34°C at admission to a tertiary care facility increased from (15/53) 28% to (51/88) 58%. Outreach education was independently associated with decreased composite outcome of death and/or severe brain injury on MRI (adjusted odds ratio 0.2; 95% confidence interval 0.07 to 0.52). Conclusion: Outreach education targeting neuroprotection for infants with moderate-to-severe HIE was associated with a reduction in death and/or severe brain injury. (© The Author(s) 2020. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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