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1279 Early Outcomes Following Referrals for Therapeutic Hypothermia - a Regional Neonatal Transfer Service Perspective
  1. PK Yajamanyam1,2,
  2. S Mohinuddin2
  1. 1Neonatal Unit, Birmingham Women’s Hospital NHS Foundation Trust, Birmingham
  2. 2Neonatal Transfer Service, Barts Health NHS Trust, London, UK

Abstract

Background and Aims Therapeutic hypothermia (TH) is now a standard of care for neonatal encephalopathy (NE). We have previously shown that referrals for TH in the London region have steadily increased since the publication of TOBY study but documentation of cooling criteria was poor (43%) before transfer to cooling centres. In this study we audit referrals for TH following introduction of a structured proforma and the early outcomes of these babies.

Methodology Prospective audit of referrals for TH to a regional neonatal transfer service over a six-month period (May–October 2011). Audit registered with the Clinical Effectiveness unit of the NHS Trust. Following transfer, cooling centres was contacted to find out early outcomes: if infants received TH for 72 hours and outcome at 7 days.

Results 43 referrals for TH were received. The median Gestation was 40(35–42) weeks, Birth-weight 3.42(2.04–4.84) Kg. Of these 38 transfers were performed. Completed proforma was available in 21 cases. TOBY criteria A were recorded in 100% of cases and TOBY criteria B in 88%. 8(21%) infants did not receive TH for 72 hours as assessed to not benefit from TH of which 3 died within 72hours. At 7 days of age 5 were discharged home and remaining 30 were inpatients.

Conclusions Our audit shows that introduction of a structured proforma can improve documentation of cooling criteria and neurological examination. We recommend that any referral for TH is carefully selected to avoid unnecessary transfer of neonates who may not benefit from TH.

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