Abstract
Objective The recent availability of servo-controlled cooling equipment on transport makes
it possible to commence active cooling at the referral unit for infants with hypoxic-ischemic
encephalopathy. This study aimed to compare the temperature and transfer variables
in passively and actively cooled babies.
Study Design This is a retrospective cohort study comparing two groups—passively cooled (July
2011 to August 2012) versus actively cooled group (September 2012 to June 2013), following
introduction of active hypothermia using servo-controlled cooling mattress by the
London Neonatal Transfer Service (NTS).
Results Seventy-six infants were passively cooled and 69 were actively cooled. There was
a significant difference between the temperatures of the two groups at each point
in the transfer episode: on arrival of NTS, during stabilization, during transfer,
and at the receiving hospital. Median time to achieve target temperature was 30 (95%
confidence interval [CI]: 23–37) minutes in actively cooled, significantly shorter
in comparison to 130 (95% CI: 83–177) minutes in passively cooled babies. Of the 69
newborns, 62 (90%) had temperature within target range at receiving center in actively
cooled group as compared with 30/76 (40%) in passively cooled group.
Conclusion The use of active cooling during neonatal transfer achieves target temperature in
a shorter period and maintains better temperature stability.
Keywords
neonate - neonatal transfer - hypoxic-ischemic encephalopathy - therapeutic hypothermia
- active cooling - servo-controlled cooling
