• Barbara Brotschi, Beate Grass, Gabriel Ramos, Ingrid Beck, Ulrike Held, Cornelia Hagmann, National Asphyxia Cooling Register Group, Ph Meyer, G Zeilinger, S M Schulzke, S Wellmann, B Wagner, K Daetwyler, M Nelle, W Bär, B Scharrer, J-F Tolsa, A Truttmann, J Schneider, R E Pfister, T M Berger, M Fontana, J P Micallef, A Birkenmayer, H U Bucher, G Natalucci, M Adams, B Frey, V Bernet, and B Latal.
• Department of Paediatric and Neonatal Intensive Care, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland. Electronic address: Barbara.brotschi@kispi.uzh.ch.
• Early Hum. Dev. 2015 Apr 1; 91 (4): 277-84.

BackgroundTherapeutic hypothermia following hypoxic ischaemic encephalopathy in term infants was introduced into Switzerland in 2005. Initial documentation of perinatal and resuscitation details was poor and neuromonitoring insufficient. In 2011, a National Asphyxia and Cooling Register was introduced.AimsTo compare management of cooled infants before and after introduction of the register concerning documentation, neuromonitoring, cooling methods and evaluation of temperature variability between cooling methods.Study DesignData of cooled infants before the register was in place (first time period: 2005-2010) and afterwards (second time period: 2011-2012) was collected with a case report form.Results150 infants were cooled during the first time period and 97 during the second time period. Most infants were cooled passively or passively with gel packs during both time periods (82% in 2005-2010 vs 70% in 2011-2012), however more infants were cooled actively during the second time period (18% versus 30%). Overall there was a significant reduction in temperature variability (p < 0.001) comparing the two time periods. A significantly higher proportion of temperature measurements within target temperature range (72% versus 77%, p < 0.001), fewer temperature measurements above (24% versus 7%, p < 0.001) and more temperatures below target range (4% versus 16%, p < 0.001) were recorded during the second time period. Neuromonitoring improved after introduction of the cooling register.ConclusionManagement of infants with HIE improved since introducing the register. Temperature variability was reduced, more temperature measurements in the target range and fewer temperature measurements above target range were observed. Neuromonitoring has improved, however imaging should be performed more often.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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