title: Comparison of Passive and Servo-Controlled Active Cooling for Infants with Hypoxic-Ischemic Encephalopathy during Neonatal Transfers.
abstract: ObjectiveThe recent availability of servo-controlled cooling equipment on transport makes it possible to commence active cooling at the referral unit for infants with hypoxic-ischemic encephalopathy. This study aimed to compare the temperature and transfer variables in passively and actively cooled babies.Study DesignThis is a retrospective cohort study comparing two groups-passively cooled (July 2011 to August 2012) versus actively cooled group (September 2012 to June 2013), following introduction of active hypothermia using servo-controlled cooling mattress by the London Neonatal Transfer Service (NTS).ResultsSeventy-six infants were passively cooled and 69 were actively cooled. There was a significant difference between the temperatures of the two groups at each point in the transfer episode: on arrival of NTS, during stabilization, during transfer, and at the receiving hospital. Median time to achieve target temperature was 30 (95% confidence interval [CI]: 23-37) minutes in actively cooled, significantly shorter in comparison to 130 (95% CI: 83-177) minutes in passively cooled babies. Of the 69 newborns, 62 (90%) had temperature within target range at receiving center in actively cooled group as compared with 30/76 (40%) in passively cooled group.ConclusionThe use of active cooling during neonatal transfer achieves target temperature in a shorter period and maintains better temperature stability.
authors.affiliation: Neonatal Transfer Service, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom.
authors.forename: Nitin
authors.initials: N
authors.lastname: Goel
authors.affiliation: Neonatal Transfer Service, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom.
authors.forename: Syed Makhtum
authors.initials: SM
authors.lastname: Mohinuddin
authors.affiliation: Neonatal Transfer Service, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom.
authors.forename: Nandiran
authors.initials: N
authors.lastname: Ratnavel
authors.affiliation: Department of Neonatal Medicine, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kempley
authors.affiliation: Department of Neonatal Medicine, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom.
authors.forename: Ajay
authors.initials: A
authors.lastname: Sinha
mesh_terms: D001513:Beds; D001831:Body Temperature; D015331:Cohort Studies; D005865:Gestational Age; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000628:therapy*; D007231:Infant, Newborn; D008131:London; D010360:Patient Transfer / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014187:Transportation of Patients / Q000379:methods*; D016896:Treatment Outcome