Cooling strategies during neonatal transport for hypoxic‐ischaemic encephalopathy
Greta Sibrecht, Franciszek Borys, Chiara Campone, Carlo Bellini, Peter G. Davis, Matteo Bruschettini
Abstract
Abstract Aim We reviewed the literature on cooling methods during transport of newborn infants with hypoxic‐ischaemic encephalopathy (HIE) born in a non‐tertiary centre and transferred to a neonatal intensive care unit for therapeutic hypothermia. Methods The electronic databases CENTRAL, MEDLINE, Embase, CINAHL, and Scopus were searched from inception up to 8 March 2022 for studies comparing cooling versus no cooling, active versus passive cooling, and servo‐controlled versus non‐servo‐controlled cooling. Odds ratio and confidence of interval were calculated for dichotomous outcomes and mean difference and confidence interval for continuous outcomes. Results The final analysis included 14 studies, 1 randomised and 13 non‐randomised, involving 1098 newborn infants. Compared with the other cooling methods, servo‐controlled active cooling was more likely to maintain body temperature within the target range of 33°C–34°C on arrival at a neonatal intensive care unit: odds ratio 13.58, 95% confidence interval 4.32–42.66, risk difference 0.33, 95% confidence interval 0.19–0.46; 224 participants; three studies; I 2 0%. The certainty of evidence was low. Only five studies reported mortality rates. Conclusion Servo‐controlled active cooling may be the preferred method during transport of newborn infants with HIE. A future area of focus should be long‐term neurodevelopmental outcomes after servo‐controlled active cooling.