TY - JOUR
T1 - Variations in care of neonates during therapeutic hypothermia
T2 - call for care practice bundle implementation
AU - on behalf of the NeoBrainNetwork
AU - Mohammad, Khorshid
AU - McIntosh, Samantha
AU - Lee, Kyong Soon
AU - Beltempo, Marc
AU - Afifi, Jehier
AU - Tremblay, Sophie
AU - Shah, Prakesh
AU - Wilson, Diane
AU - Bodani, Jaya
AU - Khurshid, Faiza
AU - Makary, Hala
AU - Ng, Eugene
AU - Wintermark, Pia
AU - Goswami, Ipsita
AU - Guillot, Mireille
AU - Hicks, Mathew
AU - Miller, Elka
AU - Pilon, Betsy
AU - Redpath, Stephanie
AU - Scott, James
AU - Shivananda, Sandesh
AU - Srinivasan, Ganesh
AU - Stavel, Miroslav
AU - Wood, Stephen
AU - Canning, Roderick
AU - Deshpandey, Akhil
AU - Kanungo, Jaideep
AU - Monterrosa, Luis
AU - Morin, Alyssa
AU - Roukema, Henry
AU - Sherlock, Rebecca
N1 - Funding Information:
P.W. is supported by FRSQ Clinical Research Scholar Career Award Senior and a Canadian Institutes of Health Research (CIHR) Project Grant.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
PY - 2023
Y1 - 2023
N2 - Background: Therapeutic hypothermia (TH) is the gold-standard treatment for moderate and severe neonatal encephalopathy (NE). Care during TH has implications for long-term outcomes. Outcome variability exists among neonatal intensive care units (NICUs) in Canada, but care variations are not understood well. This study examines variations in care practices for neonates with NE treated with TH in NICUs across Canada. Methods: A non-anonymous, web-based questionnaire was emailed to tertiary NICUs in Canada providing TH for NE to assess care practices during the first days of life and neurodevelopmental follow-up. Results: Ninety-two percent (24/26) responded. Centres followed national guidelines regarding the use of the modified Sarnat score to assess the initial severity of NE, the need to initiate TH within the first 6 h of birth, and the importance of follow-up. However, other practices varied, including ventilation mode, definition/treatment of hypotension, routine echocardiography, use of sedation, use of electroencephalogram (EEG), MRI timing, placental analysis, and follow-up duration. Conclusions: NICUs across Canada follow available national guidelines, but variations exist in practices for managing NE during TH. Development and implementation of a consensus-based care bundle for neonates during TH may reduce practice variability and improve outcomes. Impact: This survey describes the current HIE care practices and variation among tertiary centres in Canada.Variations exist in the care of neonates with NE treated with TH in NICUs across Canada.This paper Identifies areas of variation that are not discussed in detail in the national guidelines and will help to set up quality improvement initiatives.Elucidating the variation in care practices calls for the creation and implementation of a national, consensus-based care bundle, with the objective to improve the outcomes of these critically ill neonates.
AB - Background: Therapeutic hypothermia (TH) is the gold-standard treatment for moderate and severe neonatal encephalopathy (NE). Care during TH has implications for long-term outcomes. Outcome variability exists among neonatal intensive care units (NICUs) in Canada, but care variations are not understood well. This study examines variations in care practices for neonates with NE treated with TH in NICUs across Canada. Methods: A non-anonymous, web-based questionnaire was emailed to tertiary NICUs in Canada providing TH for NE to assess care practices during the first days of life and neurodevelopmental follow-up. Results: Ninety-two percent (24/26) responded. Centres followed national guidelines regarding the use of the modified Sarnat score to assess the initial severity of NE, the need to initiate TH within the first 6 h of birth, and the importance of follow-up. However, other practices varied, including ventilation mode, definition/treatment of hypotension, routine echocardiography, use of sedation, use of electroencephalogram (EEG), MRI timing, placental analysis, and follow-up duration. Conclusions: NICUs across Canada follow available national guidelines, but variations exist in practices for managing NE during TH. Development and implementation of a consensus-based care bundle for neonates during TH may reduce practice variability and improve outcomes. Impact: This survey describes the current HIE care practices and variation among tertiary centres in Canada.Variations exist in the care of neonates with NE treated with TH in NICUs across Canada.This paper Identifies areas of variation that are not discussed in detail in the national guidelines and will help to set up quality improvement initiatives.Elucidating the variation in care practices calls for the creation and implementation of a national, consensus-based care bundle, with the objective to improve the outcomes of these critically ill neonates.
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U2 - 10.1038/s41390-022-02453-6
DO - 10.1038/s41390-022-02453-6
M3 - Article
C2 - 36624286
AN - SCOPUS:85145929115
SN - 0031-3998
JO - Pediatric Research
JF - Pediatric Research
ER -