ArticlePaediatrics & child health2011
Lessons learned during implementation of therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy in a regional transport program in Ontario.
Article in Paediatrics & child health, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 33 citations in OpenAlex.
- Clinical practice guidelines for neonatal therapeutic hypothermia across European Society for Paediatric and Neonatal Intensive Care (ESPNIC) member countries: a multidisciplinary blind comparison.The Lancet regional health. Europe · 2026Article
- Strategy to Identify Infants with Hypoxic Ischemic Encephalopathy for Therapeutic Hypothermia-A Retrospective Audit.Children (Basel, Switzerland) · 2025Article
- Classical complement pathway inhibition reduces brain damage in a hypoxic ischemic encephalopathy animal model.PloS one · 2021Article
- Temporally Altered miRNA Expression in a Piglet Model of Hypoxic Ischemic Brain Injury.Molecular neurobiology · 2020Article
- The impact of high intensity care around birth on long-term neurodevelopmental outcomes.Health economics review · 2020Article
- Association between newborn screening analytes and hypoxic ischemic encephalopathy.Scientific reports · 2019Article
- Influence of timing of initiation of therapeutic hypothermia on brain MRI and neurodevelopment at 18 months in infants with HIE: a retrospective cohort study.BMJ paediatrics open · 2019Article
- Cooling in neonatal hypoxic-ischemic encephalopathy: practices and opinions on minimum standards in the state of California.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Passive hypothermia (≥35 - <36°C) during transport of newborns with hypoxic-ischaemic encephalopathy.PloS one · 2017Article
- Thioperamide treats neonatal hypoxic-ischemic encephalopathy by postsynaptic H1 receptors.Neural regeneration research · 2013Article
- Noninvasive Monitoring during Interhospital Transport of Newborn Infants.Critical care research and practice · 2013Article
- Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTherapeutic hypothermia (TH) is the first intervention to consistently show improved neurological outcomes in neonates with hypoxic ischemic encephalopathy (HIE). Since the recent introduction of TH for HIE in many centres, reviews of practices during the implementation of TH in Canada have not been published.
objectiveTo determine if eligible neonates are being offered TH and to identify any barriers to the effective implementation of TH.
methodsA retrospective review of neonates referred to a regional tertiary centre at a gestational age of 35 weeks or more with HIE was conducted.
resultsAmong 41 neonates referred, 29 (71%) were eligible for TH; among eligible patients, five were moribund and excluded, and TH was initiated in 16 (67%) of the remaining 24. Reasons for not cooling in eight eligible patients included a delay in referral (n=5, median age at referral was 14 h) and a failure to recognize the severity of HIE (n=3). Among cooled patients, median times were the following: 116 min for age at referral; 80 min for time from referral to transport team arrival; and 358 min for age at initiation of cooling. Seven (44%) patients had cooling initiated after 6 h of age.
conclusionA significant proportion of eligible patients were not offered TH, and in many cooled patients, initiation of cooling was delayed beyond the recommended 6 h. For eligible patients to benefit from TH, it is imperative that all birthing centres be made aware that TH is now widely available as an important treatment option, but also that TH is a time-sensitive therapy requiring rapid identification and referral. In the region studied, for eligible patients, referring hospitals should initiate passive cooling before arrival of the transport team. Referring hospitals should be prepared to provide early, yet safe initiation of passive cooling by having the appropriate equipment, and having staff trained in the use and monitoring of rectal temperatures.
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