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2014 ; 4
(4
): 193-200
Nephropedia Template TP
gab.com Text
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Temperature control during therapeutic hypothermia for newborn encephalopathy
using different Blanketrol devices
#MMPMID25285767
Laptook AR
; Kilbride H
; Shepherd E
; McDonald SA
; Shankaran S
; Truog W
; Das A
; Higgins RD
Ther Hypothermia Temp Manag
2014[Dec]; 4
(4
): 193-200
PMID25285767
show ga
Therapeutic hypothermia improves the survival and neurodevelopmental outcome of
infants with newborn encephalopathy of a hypoxic-ischemic origin. The NICHD
Neonatal Research Network (NRN) Whole Body Cooling trial used the Cincinnati
Sub-Zero Blanketrol II to achieve therapeutic hypothermia. The Blanketrol III is
now available and provides additional cooling modes that may result in better
temperature control. This report is a retrospective comparison of infants
undergoing hypothermia using two different cooling modes of the Blanketrol
device. Infants from the NRN trial were cooled with the Blanketrol II using the
Automatic control mode (B2 cohort) and were compared with infants from two new
NRN centers that adopted the NRN protocol and used the Blanketrol III in a
gradient mode (B3 cohort). The primary outcome was the percent time the
esophageal temperature stayed between 33°C and 34°C (target 33.5°C) during
maintenance of hypothermia. Cohorts had similar birth weight, gestational age,
and level of encephalopathy at the initiation of therapy. Baseline esophageal
temperature differed between groups (36.6°C ± 1.0°C for B2 vs. 33.9°C ± 1.2°C for
B3, p<0.0001) reflecting the practice of passive cooling during transport prior
to initiation of active device cooling in the B3 cohort. This difference
prevented comparison of temperatures during induction of hypothermia. During
maintenance of hypothermia the mean and standard deviation of the percent time
between 33°C and 34°C was similar for B2 compared to B3 cohorts (94.8% ± 0.1% vs.
95.8% ± 0.1%, respectively). Both the automatic and gradient control modes of the
Blanketrol devices appear comparable in maintaining esophageal temperature within
the target range during maintenance of therapeutic hypothermia.