Journal article
Practice Variations for Therapeutic Hypothermia in Neonates with Hypoxic-ischemic Encephalopathy: An International Survey
The Journal of pediatrics, v 274, 114181
Nov 2024
PMID: 38950817
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate variations in management of therapeutic hypothermia (TH) for neonatal hypoxic-ischemic encephalopathy (HIE) among international clinical sites and to identify areas for harmonization.
An electronic survey was sent to Children's Hospitals Neonatal Consortium site sponsors, Canadian Neonatal Network site investigators, members of the Newborn Brain Society, and American Academy of Pediatrics Neonatology chiefs.
One hundred five sites responded, with most from high-income regions (n = 95). Groupings were adapted from the United Nations regional groups: US (n = 52 sites); Canada (n = 20); Western Europe and other states excluding Canada and US Group (WEOG, n = 18); and non-WEOG (central and eastern Europe, Asia, Africa, Latin America, and Caribbean, n = 15). Regional variations were seen in the eligibility criteria for TH, such as the minimum gestational age, grading of HIE severity, use of electroencephalography, and the frequency of providing TH for mild HIE. Active TH during transport varied among regions and was less likely in smaller volume sites. Amplitude-integrated electroencephalogram and/or continuous electroencephalogram to determine eligibility for TH was used by most sites in WEOG and non-WEOG but infrequently by the US and Canada Groups. For sedation during TH, morphine was most frequently used as first choice but there was relatively high (33%) use of dexmedetomidine in the US Group. Timing of brain magnetic resonance imaging and neurodevelopmental follow-up were variable. Neurodevelopmental follow occurred earlier and more frequently, although for a shorter duration, in the non-WEOG.
We found significant variations in practices for TH for HIE across regions internationally. Future guidelines should incorporate resource availability in a global perspective.
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Details
- Title
- Practice Variations for Therapeutic Hypothermia in Neonates with Hypoxic-ischemic Encephalopathy: An International Survey
- Creators
- Kyong-Soon Lee - University of TorontoAn Massaro - Children's NationalPia Wintermark - Montreal Children's HospitalJanet Soul - Boston Children's HospitalGirija Natarajan - Wayne State UniversityMaria L.V. Dizon - Lurie Children's HospitalUlrike Mietzsch - Seattle Children's HospitalKhorshid Mohammad - University of CalgaryTai-Wei Wu - University of Southern CaliforniaAmit Chandel - Atrium Health Wake Forest BaptistJeffrey Shenberger - Connecticut Children's Medical CenterRobert DiGeronimo - University of WashingtonEric S. Peeples - University of Nebraska Medical CenterShannon Hamrick - Emory UniversityVilmaris Quinones Cardona - St. Christopher's Hospital for ChildrenRakesh Rao - Washington University in St. Louis
- Publication Details
- The Journal of pediatrics, v 274, 114181
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001277140600001
- Scopus ID
- 2-s2.0-85199061046
- Other Identifier
- 991022202106304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics