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Reference: Azzopardi, D, Strohm, B, Edwards, AD et al., (2009). Treatment of asphyxiated newborns with moderate hypothermia in routine clinical practice: how cooling is managed in the UK outside a clinical trial. Archives of disease in childhood. Fetal and neonatal edition, 94 (4), F260-F264.Citable link to this page:

 

Treatment of asphyxiated newborns with moderate hypothermia in routine clinical practice: how cooling is managed in the UK outside a clinical trial.

Abstract: BACKGROUND: This is a phase 4 study of infants registered with the UK TOBY Cooling Register from December 2006 to February 2008. The registry was established on completion of enrolLment to the TOBY randomised trial of treatment with whole body hypothermia following perinatal asphyxia at the end of November 2006. METHODS: We collected information about patient characteristics, condition at birth, resuscitation details, severity of encephalopathy, hourly temperature record, clinical complications and outcomes before hospital discharge. RESULTS: 120 infants born at a median of 40 (IQR 38-41) weeks' gestation and weighing a median of 3287 (IQR 2895-3710) g at birth were studied. Cooling was started at a median of 3 h 54 min (IQR 2 h-5 h 32 min) after birth. All but three infants underwent whole body cooling. The mean (SD) rectal temperature from 6 to 72 h of the cooling period was 33.57 degrees C (0.51 degrees C). The daily encephalopathy score fell: median (IQR) 11 (6-15), 9.7 (5-14), 8 (5-13) and 7 (2-12) on days 1-4 after birth, respectively. 51% of the infants established full oral feeding at a median (range) of 9 (4-24) days. 26% of the study infants died. MRI was consistent with hypoxia-ischaemia in most cases. Clinical complications were not considered to be due to hypothermia. CONCLUSION: In the UK, therapeutic hypothermia following perinatal asphyxia is increasingly being provided. The target body temperature is successfully achieved and the clinical complications observed were not attributed to hypothermia. Treatment with hypothermia may have prevented the worsening of the encephalopathy that is commonly observed following asphyxia.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Accepted Manuscript Funder: Department of Health   Notes:This is the accepted manuscript version of the article. The final version is available online from BMJ at: http://dx.doi.org/10.1136/adc.2008.146977

Bibliographic Details

Publisher: BMJ Publishing Group

Publisher Website: http://group.bmj.com/products/journals

Journal: Archives of disease in childhood. Fetal and neonatal editionsee more from them

Publication Website: http://fn.bmj.com/

Issue Date: 2009

pages:F260-F264Identifiers

Urn: uuid:e1291c09-33e3-4105-ae81-ae5fe24daaa4

Source identifier: 236862

Eissn: 1468-2052

Doi: https://doi.org/10.1136/adc.2008.146977

Issn: 1359-2998 Item Description

Type: Journal article;

Language: eng

Version: Accepted ManuscriptKeywords: Steering Group and TOBY Cooling Register participants Rectum Humans Hypoxia-Ischemia, Brain Asphyxia Neonatorum Birth Weight Magnetic Resonance Imaging Body Temperature Hypothermia, Induced Severity of Illness Index Registries Age Factors Infant, Newborn Professional Practice Great Britain Randomized Controlled Trials as Topic Clinical Trials, Phase IV as Topic Tiny URL: pubs:236862

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Author: Azzopardi, D - - - Strohm, B - institutionUniversity of Oxford Oxford, MSD, Nuffield Department of Population Health, NPEU - - -

Source: https://ora.ox.ac.uk/objects/uuid:e1291c09-33e3-4105-ae81-ae5fe24daaa4



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