The decision to advise a community physician to initiate passive cooling is a delicate one, taking into account the clinical picture, experience of the physician, resources in the community hospital, availability of the NNTT and estimated time to arrive in community hospital. Back-transformed model coefficients can therefore be interpreted as medians. Cooling for newborns with hypoxic ischaemic encephalopathyHypothermia for neonatal hypoxic ischemic encephalopathy: An updated systematic review and meta-analysisWindow of opportunity of cerebral hypothermia for postischemic white matter injury in the near-term fetal sheepCerebral hypothermia is not neuroprotective when started after postischemic seizures in fetal sheepModerate hypothermia to treat perinatal asphyxial encephalopathyCanadian Paediatric Society, Fetus and Newborn CommitteeHypothermia for newborns with hypoxic ischemic encephalopathyNational Institute of Child Health and Human Development Neonatal Research NetworkWhole-body hypothermia for neonates with hypoxic-ischemic encephalopathyPassive cooling for initiation of therapeutic hypothermia in neonatal encephalopathyWhole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: A randomized controlled trialNeuroprotection with prolonged head cooling started before postischemic seizures in fetal sheepImmediate hypothermia is not neuroprotective after severe hypoxia-ischemia and is deleterious when delayed by 12 hours in neonatal ratsTime is brain: Starting therapeutic hypothermia within three hours after birth improves motor outcome in asphyxiated newbornsNewborns referred for therapeutic hypothermia: Association between initial degree of encephalopathy and severity of brain injury (what about the newborns with mild encephalopathy on admission? It's dangerous and may increase the risk to several diseases similar to active smoking (one's exposure to smoke emitted from the cigarettes he or she is smoking) although the risk is of lower magnitude. If passive cooling alone fails to lower core temperature, the NNTT begins active cooling, as described by Kendall et al. Active shipping configurations are usually leased containers with advanced temperature controls that are often powered by electricity and/or battery.
The distance to travel varies between the two geographical areas served by SickKids and CHEO. Note the logarithmic scaling of the horizontal and vertical axis.Correlation between time of initiation of therapeutic hypothermia and age when target temperature was achieved. For permissions, please e-mail: journals.permissions@oup.com
As such, we did not have enough power to detect an effect due to site in our regression model. Awaiting advice from a tertiary care centre or the arrival of the NNTT significantly delayed the initiation of TH. The Research Ethics Boards of both institutions approved the study.Oxford University Press is a department of the University of Oxford. On average, subjects were not able to recover to a core temperature below 37.5°C during a 20-minute rehab period when provided rehydration and the opportunity to completely remove TPC for passive cooling. Sensor devices track the temperature in each thermal zone. Nonauscultatory clinical criteria are sensitive for cardiac pathology in low-risk paediatric heart murmurs
All over the country, people are installing solar panels on their roofs to produce their own electricity and save some cash. As such, we did not have enough power to detect an effect due to site in our regression model.
Advice regarding initiation of passive cooling or to await further evaluation by the NNTT, once on site, is provided, based on the clinical scenario, findings on clinical exam, availability of the NNTT, distance to travel and likelihood of the baby arriving at the tertiary care NICU before 6 hours of life.
A doubling of time to initiation of TH corresponds to a 24% (95% CI 18% to 30%) increase in median time to reach target core temperature.Initiating passive cooling at the referring centre, before transfer, is critical to faster achievement of target core temperature in asphyxiated infants. A relatively simple way for a device driver to support thermal management is to implement the GUID_THERMAL_COOLING_INTERFACE driver interface. )Rectal temperature in the newborn after birth asphyxiaEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research NetworkTemperature profile and outcomes of neonates undergoing whole body hypothermia for neonatal hypoxic-ischemic encephalopathyPassive cooling during transport of asphyxiated term newbornsPassive induction of hypothermia during transport of asphyxiated infants: A risk of excessive coolingTherapeutic hypothermia on neonatal transport: 4-year experience in a single NICUA randomized clinical trial of therapeutic hypothermia mode during transport for neonatal encephalopathyActive versus passive cooling during neonatal transportAntecedents of neonatal encephalopathy in the vermont oxford network encephalopathy registry© The Author 2017. The Research Ethics Boards of both institutions approved the study.Oxford University Press is a department of the University of Oxford. Passive smoking is the exposure to cigarettes smoke emitted from cigarettes smoke by other person. Waiting for advice from a tertiary care NICU was independently associated with a delay of 50 minutes (median) in the time of initiation of TH, while waiting for the NNTT was independently associated with a median delay of 177 minutes (Time of initiation of therapeutic hypothermia according to who initiated it. Greater outreach, education and development of clinical care pathways, with emphasis on regular temperature monitoring, are needed to improve optimal delivery of TH in a safe fashion and, ultimately, to improve outcomes.The authors would like to acknowledge the contribution of Dr Amr El Shahed for his assistance in collecting data at SickKids.Correspondence: Brigitte Lemyre, Division of Neonatology, Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1.
of fire suppression. Note the logarithmic scaling of the horizontal and vertical axis.Correlation between time of initiation of therapeutic hypothermia and age when target temperature was achieved.
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