Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy-Drift in Clinical Practice in Swiss Neonatal (Intensive Care) Units?

IF 0.8 4区医学 Q4 CRITICAL CARE MEDICINE

Therapeutic hypothermia and temperature management Pub Date : 2025-05-15 DOI:10.1089/ther.2025.0019

Charlotte Lengauer, Mark Adams, Barbara Brotschi, Michael Kleber, Vera Bernet, Maren Tomaske, Dirk Bassler, Beate Grass

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Abstract

The objective of this study was to assess the adherence to inclusion criteria for therapeutic hypothermia (TH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to survey current attitudes on TH. This multicenter observational study therefore combined a retrospective analysis of the Swiss National Asphyxia and Cooling Register (2011-2023) and a prospective survey (2024) among neonatologists in the Canton of Zurich, Switzerland. A total of 456 neonates with HIE were registered in the Swiss National Asphyxia and Cooling Register in the Canton of Zurich, Switzerland, between 2011 and 2023. The rate of TH (52.6% [2011-2017] versus 52.0% [2018-2023]) as well as the incidence of off-protocol cooling remained stable over time (p = 0.614). The survey response rate was 69.5% (57/82). Difficulties with clinical grading of encephalopathy were identified. Subjectively, respondents considered themselves more generous to initiate TH. In conclusion, register data reflected good adherence to inclusion criteria for TH. The survey confirmed willingness to consider TH in milder HIE cases. However, there was no drift in clinical practice-yet?

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低温治疗在瑞士新生儿重症监护病房治疗缺氧缺血性脑病的临床实践？

本研究的目的是评估缺氧缺血性脑病（HIE）新生儿治疗性低温治疗（TH）纳入标准的依从性，并调查目前对TH的态度。因此，这项多中心观察性研究结合了对瑞士国家窒息和降温登记册（2011-2023）的回顾性分析和对瑞士苏黎世州新生儿学家的前瞻性调查（2024）。2011年至2023年间，共有456名新生儿在瑞士苏黎世州的瑞士国家窒息和降温登记处登记。TH的发生率（52.6%[2011-2017]对52.0%[2018-2023]）以及非方案冷却的发生率随时间保持稳定（p = 0.614）。调查回复率为69.5%（57/82）。确定了脑病临床分级的困难。主观上，受访者认为自己更慷慨地发起TH。总之，登记数据反映了对TH纳入标准的良好遵守。调查证实在较轻的HIE病例中愿意考虑TH。然而，在临床实践中还没有出现漂移现象。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic hypothermia and temperature management CRITICAL CARE MEDICINE-

CiteScore

2.50

自引率

8.30%

发文量

期刊介绍： Therapeutic Hypothermia and Temperature Management is the first and only journal to cover all aspects of hypothermia and temperature considerations relevant to this exciting field, including its application in cardiac arrest, spinal cord and traumatic brain injury, stroke, burns, and much more. The Journal provides a strong multidisciplinary forum to ensure that research advances are well disseminated, and that therapeutic hypothermia is well understood and used effectively to enhance patient outcomes. Novel findings from translational preclinical investigations as well as clinical studies and trials are featured in original articles, state-of-the-art review articles, protocols and best practices. Therapeutic Hypothermia and Temperature Management coverage includes: Temperature mechanisms and cooling strategies Protocols, risk factors, and drug interventions Intraoperative considerations Post-resuscitation cooling ICU management.