title: Hypothermia for neonatal encephalopathy: Nationwide Survey of Clinical Practice in Japan as of August 2010.
abstract: BACKGROUND
  Therapeutic hypothermia is now recommended as a standard of care for neonatal encephalopathy. Although adherence to standard cooling protocols used in the phase-III trials is essential, empiric approaches have prevailed in Japan.
  
  
  OBJECTIVE
  To elucidate the gap between the standard cooling methods and the current practice in Japan.
  
  
  METHODS
  In July 2010, a questionnaire regarding the practice of neonatal encephalopathy was mailed to clinical leads of registered neonatal intensive care units.
  
  
  RESULTS
  56.2% of the units were incapable of offering therapeutic hypothermia because of the reasons such as the shortage of human/medical resources (85.1%) and limited number of cases (21.1%). Eighty-nine centres provided therapeutic hypothermia using either selective-head cooling (88.8%) or whole-body cooling (11.2%). Various target temperatures and cooling durations were used; 20.2% of the units cooled infants without using purpose-built equipments, whereas 14.6% did not continuously monitor the body temperature.
  
  
  CONCLUSIONS
  Only 43.8% of the units provided therapeutic hypothermia. Even in centres where hypothermia was offered, adherence to the standard protocols was extremely poor. To secure the safety and efficacy, further promotion of the standard cooling protocols is required; an efficient cooling centre network has to be established by optimizing the work forth distribution and transportation system.
authors.affiliation: Centre for Developmental & Cognitive Neuroscience, Department of Paediatrics, Kurume University School of Medicine, Fukuoka, Japan. o.iwata@ucl.ac.uk
authors.forename: Osuke
authors.initials: O
authors.lastname: Iwata
authors.forename: Makoto
authors.initials: M
authors.lastname: Nabetani
authors.forename: Toshiki
authors.initials: T
authors.lastname: Takenouchi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iwaibara
authors.forename: Sachiko
authors.initials: S
authors.lastname: Iwata
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D001927:Brain Diseases / Q000628:therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007035:Hypothermia / Q000628:therapy*; D007036:Hypothermia, Induced / Q000592:standards*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007564:Japan; D010818:Practice Patterns, Physicians'