Effectiveness of reaching and maintaining therapeutic hypothermia target temperature using low‐cost devices in newborns with hypoxic–ischemic encephalopathy
| Autor: | Daniela Pereira Rodrigues, Gabriel Fernando Todeschi Variane, Mauricio Ferreira Magalhães, Clery Bernardi Gallaci, Paulo R. Pachi, Marco Aurélio Palazzi Sáfadi, Alexandre Netto, Rafaela Fabri Rodrigues Pietrobom, Francisco Paulo Martins Rodrigues, Adriana Nishimoto Kinoshita |
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| Rok vydání: | 2021 |
| Předmět: |
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0301 basic medicine Histology Encephalopathy Gestational Age Hypoxic Ischemic Encephalopathy Body Temperature 03 medical and health sciences 0302 clinical medicine Hypothermia Induced medicine Coagulopathy Humans Adverse effect Ecology Evolution Behavior and Systematics Retrospective Studies business.industry Infant Newborn Gestational age Hypothermia medicine.disease Pulmonary hypertension Perinatal asphyxia Cross-Sectional Studies Treatment Outcome 030104 developmental biology Anesthesia Hypoxia-Ischemia Brain Female Anatomy medicine.symptom business 030217 neurology & neurosurgery Biotechnology |
| Zdroj: | The Anatomical Record. 304:1217-1223 |
| ISSN: | 1932-8494 1932-8486 |
| DOI: | 10.1002/ar.24615 |
| Popis: | Therapeutic hypothermia (TH) using servo-controlled cooling devices has proved to be a safe and effective method to reduce mortality and sequelae in neonates with hypoxic-ischemic encephalopathy (HIE). However, such cooling devices can be expensive and have limited availability in low- and middle-income countries. To evaluate the feasibility and effectiveness of low-cost cooling devices (ice packs) to reach and maintain the target temperature in newborns with moderate or severe HIE. Descriptive retrospective cross-sectional study, including newborns with gestational age ≥35 weeks, weight ≥1800 g, with diagnosis of moderate or severe HIE, submitted to whole body hypothermia using ice packs for 72 hr. Data was obtained from medical records and databases. The thermal curves of each patient, time spent at the target temperature and rewarming time were evaluated. Complications directly related to therapeutic hypothermia, evolution, and early outcomes before hospital discharge were analyzed. Seventy-one newborns met the criteria for TH, and 61 completed the entire cooling period and were included in the final analysis. The average time to reach the target temperature was 1.50 ± 1.3 hr. The mean temperature during the cooling period was 33.5°C (±0.62). 82.32% of the measurements were within the target temperature range (from 33 to 34°C). The following adverse events were observed during TH: pulmonary hypertension 11.3%, arrhythmia 4.2%, and coagulopathy 26.7%. Whole body hypothermia using low-cost devices proved to be an effective method in the absence of availability of servo-controlled devices, representing a plausible option in restricted resource settings. |
| Databáze: | OpenAIRE |
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