title: Therapeutic hypothermia for neonatal encephalopathy: a report from the first 3 years of the Baby Cooling Registry of Japan.
abstract: Therapeutic hypothermia is recommended for moderate and severe neonatal encephalopathy, but is being applied to a wider range of neonates than originally envisaged. To examine the clinical use of therapeutic hypothermia, data collected during the first 3 years (2012-2014) of the Baby Cooling Registry of Japan were analysed. Of 485 cooled neonates, 96.5% were ≥36 weeks gestation and 99.4% weighed ≥1,800 g. Severe acidosis (pH < 7 or base deficit ≥16 mmol/L) was present in 68.9%, and 96.7% required resuscitation for >10 min. Stage II/III encephalopathy was evident in 88.3%; hypotonia, seizures and abnormal amplitude-integrated electroencephalogram were observed in the majority of the remainder. In-hospital mortality was 2.7%; 90.7% were discharged home. Apgar scores and severity of acidosis/encephalopathy did not change over time. The time to reach the target temperature was shorter in 2014 than in 2012. The proportion undergoing whole-body cooling rose from 45.4% to 81.6%, while selective head cooling fell over time. Mortality, duration of mechanical ventilation and requirement for tube feeding at discharge remained unchanged. Adherence to standard cooling protocols was high throughout, with a consistent trend towards cooling being achieved more promptly. The mortality rate of cooled neonates was considerably lower than that reported in previous studies.
authors.affiliation: Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Kennosuke
authors.initials: K
authors.lastname: Tsuda
authors.affiliation: Center for Advanced Medical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Mukai
authors.affiliation: Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.|Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Iwata
authors.affiliation: Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shibasaki
authors.affiliation: Division of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tokuhisa
authors.affiliation: Department of Pediatrics, Perinatal Medical Center, Himeji Red Cross Hospital, Hyogo, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ioroi
authors.affiliation: Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Nanae
authors.initials: N
authors.lastname: Yutaka
authors.affiliation: Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Takeuchi
authors.affiliation: Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Takenouchi
authors.affiliation: Faculty of Informatics, Shizuoka University, Shizuoka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Araki
authors.affiliation: Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Sobajima
authors.affiliation: Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
authors.affiliation: Division of Neonatology, Nihon University Itabashi Hospital, Tokyo, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Hosono
authors.affiliation: Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nabetani
authors.affiliation: Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.|Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Osuke
authors.initials: O
authors.lastname: Iwata
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D007564:Japan; D012042:Registries; D016896:Treatment Outcome