• Osuke Iwata, Makoto Nabetani, Toshiki Takenouchi, Takayuki Iwaibara, Sachiko Iwata, Masanori Tamura, Working Group on Therapeutic Hypothermia for Neonatal Encephalopathy, Ministry of Health, Labor and Welfare, Japan, and Japan Society for Perinatal and Neonatal Medicine.
• Centre for Developmental & Cognitive Neuroscience, Department of Paediatrics, Kurume University School of Medicine, Fukuoka, Japan. o.iwata@ucl.ac.uk
• Acta Paediatr. 2012 May 1;101(5):e197-202.

BackgroundTherapeutic hypothermia is now recommended as a standard of care for neonatal encephalopathy. Although adherence to standard cooling protocols used in the phase-III trials is essential, empiric approaches have prevailed in Japan.AimTo elucidate the gap between the standard cooling methods and the current practice in Japan.MethodIn July 2010, a questionnaire regarding the practice of neonatal encephalopathy was mailed to clinical leads of registered neonatal intensive care units.Result56.2% of the units were incapable of offering therapeutic hypothermia because of the reasons such as the shortage of human/medical resources (85.1%) and limited number of cases (21.1%). Eighty-nine centres provided therapeutic hypothermia using either selective-head cooling (88.8%) or whole-body cooling (11.2%). Various target temperatures and cooling durations were used; 20.2% of the units cooled infants without using purpose-built equipments, whereas 14.6% did not continuously monitor the body temperature.DiscussionOnly 43.8% of the units provided therapeutic hypothermia. Even in centres where hypothermia was offered, adherence to the standard protocols was extremely poor. To secure the safety and efficacy, further promotion of the standard cooling protocols is required; an efficient cooling centre network has to be established by optimizing the work forth distribution and transportation system.© 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

17 keywords...

hide…