Therapeutic Hypothermia in Brazil: A MultiProfessional National Survey

Abstract

Objective To determine the rate of therapeutic hypothermia (TH) use, current practices, and long-term follow-up. Study Design Prospective cross-sectional national survey with 19 questions related to the assessment of hypoxic–ischemic encephalopathy (HIE) and TH practices. An online questionnaire was made available to health care professionals working in neonatal care in Brazil. Results A total of 1,092 professionals replied, of which 681 (62%) reported using TH in their units. Of these, 624 (92%) provided TH practices details: 136 (20%) did not use any neurologic score or amplitude-integrated electroencephalogram (aEEG) to assess encephalopathy and 81(13%) did not answer this question. Any specific training for encephalopathy assessment was provided to only 81/407 (19%) professionals. Infants with mild HIE are cooled according to 184 (29%) of the respondents. Significant variations in practice were noticed concerning time of initiation and cooling methods, site of temperature measurements and monitoring, and access to aEEG, electroencephalogram (EEG), and neurology consultation. Only 19% could perform a brain magnetic resonance imaging (MRI), and 31% reported having a well-established follow-up program for these infants. Conclusion TH has been implemented in Brazil but with significant heterogeneity for most aspects of hypothermia practices, which may affect safety or efficacy of the therapy. A step forward toward quality improvement is important.

Neonatal hypoxic-ischemic encephalopathy diagnosis and treatment: a National Survey in China

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Effectiveness of reaching and maintaining therapeutic hypothermia target temperature using low‐cost devices in newborns with hypoxic–ischemic encephalopathy

“…Among the professionals that used TH, only 26.4% reported the use of servo‐controlled devices, while 53% used ice packs as the method of choice. This has been the case of more than half of the neonatal units in Brazil, which highlights the relevance of our study, showing the feasibility and effectiveness of using ice packs as an alternative, low‐cost method of cooling (Variane et al, 2018).…”

The Canadian Congenital Diaphragmatic Hernia Collaborative Mobile App: A National Guideline Implementation Strategy

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