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Am J Perinatol 2017; 34(01): 19-25
DOI: 10.1055/s-0036-1584151
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparison of Passive and Servo-Controlled Active Cooling for Infants with Hypoxic-Ischemic Encephalopathy during Neonatal Transfers

Nitin Goel
1   Neonatal Transfer Service, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
,
Syed Makhtum Mohinuddin
1   Neonatal Transfer Service, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
2   Department of Neonatal Medicine, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
3   School of Health Sciences, City University, London, United Kingdom
,
Nandiran Ratnavel
1   Neonatal Transfer Service, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
2   Department of Neonatal Medicine, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
,
Stephen Kempley
2   Department of Neonatal Medicine, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
4   Centre for Paediatrics, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
,
Ajay Sinha
2   Department of Neonatal Medicine, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom
4   Centre for Paediatrics, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
› Author Affiliations
Further Information

Publication History

19 December 2015

30 March 2016

Publication Date:
16 May 2016 (online)

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Abstract

Objective The 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 Design This 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).

Results Seventy-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.

Conclusion The use of active cooling during neonatal transfer achieves target temperature in a shorter period and maintains better temperature stability.

Keywords

neonate - neonatal transfer - hypoxic-ischemic encephalopathy - therapeutic hypothermia - active cooling - servo-controlled cooling
 

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