title: Passive hypothermia (≥35 - <36°C) during transport of newborns with hypoxic-ischaemic encephalopathy.
abstract: BACKGROUND
  Hypothermia initiated in the first six hours of life in term infants with hypoxic ischemic encephalopathy reduces the risk of death and severe neurological sequelae. Our study's principal objective was to evaluate transport predictors potentially influencing arrival in NICU (Neonatal Intensive Care Unit) at a temperature ≥35-<36°C.
  
  
  RESULTS
  A multi-centric, prospective cohort study was conducted during 18 months by the three Neonatal Transport Teams and 13 NICUs. Newborns were selected for inclusion according to biological and clinical criteria before transport using passive hypothermia using a target temperature of ≥35-<36°C. Data on 120 of 126 inclusions were available for analysis. Thirty-three percent of the children arrived in NICU with the target temperature of ≥35-<36°C. The mean temperature for the whole group of infants on arrival in NICU was 35.4°C (34.3-36.5). The median age of all infants on arrival in NICU was 3h03min [2h25min-3h56min]. Three infants arrived in NICU with a temperature of <33°C and eleven with a temperature ≥37°C. Adrenaline during resuscitation was associated with a lower mean temperature on arrival in NICU.
  
  
  CONCLUSIONS
  Our strategy using ≥35-<36°C passive hypothermia combined with short transport times had little effect on temperature after the arrival of Neonatal Transport Team although did reduce numbers of infants arriving in NICU in deep hypothermia. For those infants where hypothermia was discontinued in NICU our strategy facilitated re-warming. Re-adjustment to a lower target temperature to ≥34.5-<35.5°C may reduce the proportion of infants with high/normothermic temperatures.
authors.affiliation: SMUR Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Sellam
authors.affiliation: SMUR Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.
authors.forename: Noëlla
authors.initials: N
authors.lastname: Lode
authors.affiliation: SMUR Pédiatrique, AP-HP, Hôpital André Gregoire, Montreuil-sous-Bois, France.
authors.forename: Azzedine
authors.initials: A
authors.lastname: Ayachi
authors.affiliation: SMUR Pédiatrique, AP-HP, Hôpital Clamart, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Jourdain
authors.affiliation: Réanimation Pédiatrique (PICU), Hôpital Robert Debré, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Dauger
authors.affiliation: SMUR Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.|Réanimation Pédiatrique (PICU), Hôpital Robert Debré, Paris, France.|Portex Unit, Critical Care Group - Portex Unit, Institute of Child Health, University College London, London, United Kingdom.|London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Jones
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007035:Hypothermia; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D010360:Patient Transfer; D011446:Prospective Studies; D013696:Temperature; D014187:Transportation of Patients / Q000706:statistics & numerical data*