title: [Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)].
abstract: BACKGROUND
  Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment.
  
  
  METHODS
  The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m(2)); two level i centers, five level ii centers, and five level iii hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport.
  
  
  RESULTS
  From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%).
  
  
  CONCLUSIONS
  The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy.
authors: Unidad de Neonatología, Hospital Universitario de Burgos, Burgos, España. Electronic address: jusoru@hotmail.com.
authors: J
authors: J
authors: Arnáez
authors: Unidad de Neonatología, Hospital Universitario de Burgos, Burgos, España.
authors: C
authors: C
authors: Vega
authors: Unidad de Neonatología, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, España.
authors: A
authors: A
authors: García-Alix
authors: Unidad de Neonatología, Hospital Universitario de Salamanca, Salamanca, España.
authors: E P
authors: EP
authors: Gutiérrez
authors: Unidad de Neonatología, Hospital Universitario Río Hortega, Valladolid, España.
authors: S
authors: S
authors: Caserío
authors: Unidad de Neonatología, Hospital Nuestra Señora de Sonsoles, Ávila, España.
authors: M P
authors: MP
authors: Jiménez
authors: Unidad de Neonatología, Hospital Universitario de León, León, España.
authors: L
authors: L
authors: Castañón
authors: Unidad de Neonatología, Hospital San Pedro de Logroño, Logroño, España.
authors: I
authors: I
authors: Esteban
authors: Unidad de Neonatología, Hospital General de Segovia, Segovia, España.
authors: M
authors: M
authors: Hortelano
authors: Unidad de Neonatología, Hospital General de Zamora, Zamora, España.
authors: N
authors: N
authors: Hernández
authors: Unidad de Neonatología, Hospital Santa Bárbara, Soria, España.
authors: M
authors: M
authors: Serrano
authors: Unidad de Neonatología, Hospital El Bierzo, Ponferrada, León, España.
authors: T
authors: T
authors: Prada
authors: Servicio de Pediatría, Hospital Santiago Apóstol, Miranda de Ebro, Burgos, España.
authors: P
authors: P
authors: Diego
authors: Servicio de Pediatría, Hospital Santos Reyes, Aranda de Duero, Burgos, España.
authors: F
authors: F
authors: Barbadillo
mesh_terms: D002985:Clinical Protocols; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000628:therapy*; D007231:Infant, Newborn; D055048:Integrative Medicine; D008297:Male; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011446:Prospective Studies
keywords: Asfixia perinatal; Clinical pathway; Encefalopatía hipóxico-isquémica; Hypoxic-ischemic encephalopathy; Perinatalasphyxia; Program; Programa; Vía clínica