Title | Hypothermia therapy for neonatal hypoxic ischemic encephalopathy in the state of California. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Kracer B, Hintz SR, Van Meurs KP, Lee HC |
Journal | J Pediatr |
Volume | 165 |
Issue | 2 |
Pagination | 267-73 |
Date Published | 2014 Aug |
ISSN | 1097-6833 |
Keywords | California, Female, Hospital Mortality, Humans, Hypothermia, Induced, Hypoxia-Ischemia, Brain, Infant, Newborn, Intensive Care Units, Neonatal, Logistic Models, Male, Treatment Outcome |
Abstract | OBJECTIVE: To characterize the implementation of hypothermia for neonatal hypoxic ischemic encephalopathy (HIE) in a population-based cohort. STUDY DESIGN: Using the California Perinatal Quality Care Collaborative and California Perinatal Transport System linked 2010-2012 datasets, we categorized infants≥36 weeks' gestation with HIE as receiving hypothermia or normothermia. Sociodemographic and clinical factors were compared, and multivariable logistic regression was used to determine factors associated with hypothermia therapy. RESULTS: There were 238 reported encephalopathy cases in 2010, 280 in 2011, and 311 in 2012. Hypothermia therapy use in newborns with HIE increased from 59% to 73% across the study period, mainly occurring in newborns with mild or moderate encephalopathy. A total of 36 centers provided hypothermia and cared for 94% of infants, with the remaining 6% being cared for at one of 25 other centers. Of the centers providing hypothermia, 12 centers performed hypothermia therapy to more than 20 patients during the 3-year study period, and 24 centers cared for <20 patients receiving hypothermia. In-hospital mortality was 13%, which primarily was associated with the severity of encephalopathy. CONCLUSIONS: Our findings highlight an opportunity to explore practice-site variation and to develop quality improvement interventions to assure consistent evidence-based care of term infants with HIE and appropriate application of hypothermia therapy for eligible newborns. |
DOI | 10.1016/j.jpeds.2014.04.052 |
Alternate Journal | J. Pediatr. |
PubMed ID | 24929331 |
PubMed Central ID | PMC4111956 |
Grant List | K23HD068400 / HD / NICHD NIH HHS / United States K23 HD068400 / HD / NICHD NIH HHS / United States HD07249 / HD / NICHD NIH HHS / United States T32 HD007249 / HD / NICHD NIH HHS / United States U10 HD027880 / HD / NICHD NIH HHS / United States U10HD027880S1 / HD / NICHD NIH HHS / United States 3U10HD02788019S1 / HD / NICHD NIH HHS / United States D34HP16047 / / PHS HHS / United States |