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Hypothermia for Birth Asphyxia


JACK

Do you use Head Cooling/Total Body Cooling for Birth Asphyxia ?  

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It would be nice to find out practices around the world regarding Head Cooling / Total Body Cooling for Birth Asphyxia.

I have added a poll for this post.

As for us, we do have the Olympus Head cooling apparatus but use it rarely. Maybe it is because we (the doctors and nurses ) are not comfortable with it. Seems to be related more to initial resistance while adopting a new technology rather than the equipment itself...which is remarkably simple to use.

Edited by JACK
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I think you describe a common problem - the difficulty of implementation.

That introduction of a new treatment modality goes beyond the actual intervention, and includes education, putting a desired strategy into "words", writing it down, the learning curve when staff starts to do the intervention etc-etc. As I know that you already know :)

My suggestion - form a working group including several categories of staff and discuss the medical, nursing and techn aspects of cooling.

We pretty much use the TOBY protocols (as we were a center in the trial), and I am quite sure there are lots of documentation on their web site still:

https://www.npeu.ox.ac.uk/toby/protocol

https://www.npeu.ox.ac.uk/toby/leaflets

https://www.npeu.ox.ac.uk/toby/dcfs

Good luck and I wish you the best with the implementation!

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@Stefan: Thank you for the advice.

The problem is that many of the staff (senior to junior) appear to be skeptical of the usefulness of this modality of treatment. Also the nursing staff appear to be put off by the fact of the added manipulation necessitated when applying the head cooling apparatus. Then there is the overall inertia against adopting a "new" treatment.

I think it will take time and more time !!!

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If during hypothermia septical shock occurs is it the reason to discontinuate hypothermia?

I am not sure of specific guidelines for this point but maybe we can draw from the recommendation in the TOBY guidelines :

"Cooling may produce adverse respiratory or cardiovascular effects and should be used with caution in infants with an unstable respiratory or cardiovascular condition."

(source: https://www.npeu.ox.ac.uk/files/downloads/tobyregister/Register-Clinicans-Handbook1-v4-07-06-10.pdf )

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