TY - JOUR
T1 - Therapeutic hypothermia for neonatal encephalopathy
T2 - JSPNM & MHLW Japan Working Group Practice Guidelines. Consensus Statement from the Working Group on Therapeutic Hypothermia for Neonatal Encephalopathy, Ministry of Health, Labor and Welfare (MHLW), Japan, and Japan Society for Perinatal and Neonatal Medicine (JSPNM)
AU - Takenouchi, Toshiki
AU - Iwata, Osuke
AU - Nabetani, Makoto
AU - Tamura, Masanori
N1 - Funding Information:
This work is supported by The Japanese Ministry of Health, Labor and Welfare (Clinical and Practical Research on the Japanese Guideline of Neonatal Cardio-Pulmonary Resuscitation Based on Consensus 2010).
Funding Information:
O. Iwata is funded by the Morinaga Foundation for Health & Nutrition, the Japan Society for the Promotion of Science, The Japanese Ministry of Education, Culture, Sports, Science and Technology (Grant-in-Aid for Scientific Research C21591339 ) and The Japanese Ministry of Health, Labor and Welfare (Research Grant 21B-5 for Nervous and Mental Disorders).
PY - 2012/2
Y1 - 2012/2
N2 - Neonatal encephalopathy (NE) secondary to intrapartum asphyxia remains a major cause of post-natal death and permanent neurological deficits worldwide. Supportive therapy has been the mainstay of the treatment until recent series of large clinical trials demonstrating benefit of therapeutic hypothermia (TH) in this high risk population. Now the International Liaison Committee on Resuscitation (ILCOR) recommends TH as a standard of care with the protocols used in the large clinical trials as tentative standard protocols. Our goal is to develop a nationwide consensus practice guideline not only consistent with the international standard protocols but also practical and compatible with the current medical system in Japan. In summary, TH should be offered to newborn infants born ≥36. weeks gestational age and birth weight ≥1800. g exhibiting clinical signs of moderate to severe NE as well as evidence of hypoxia-ischemia, i.e. 10 min Apgar score ≤5, a need for resuscitation at 10. min, blood pH < 7.00, or base deficit ≥16. mmol/L. TH should be conducted in the NICUs capable of multidisciplinary care and under the standard protocols, i.e. utilization of cooling device, target (rectal or esophageal) temperatures at 33.5 ± 0.5 and 34.5 ± 0.5 °C for whole body and selective head cooling respectively, duration of TH for 72. h, gradual rewarming not exceeding the rate of 0.5 °C/h. Long term follow-up with multidisciplinary approach including standardized psychological assessment is warranted.
AB - Neonatal encephalopathy (NE) secondary to intrapartum asphyxia remains a major cause of post-natal death and permanent neurological deficits worldwide. Supportive therapy has been the mainstay of the treatment until recent series of large clinical trials demonstrating benefit of therapeutic hypothermia (TH) in this high risk population. Now the International Liaison Committee on Resuscitation (ILCOR) recommends TH as a standard of care with the protocols used in the large clinical trials as tentative standard protocols. Our goal is to develop a nationwide consensus practice guideline not only consistent with the international standard protocols but also practical and compatible with the current medical system in Japan. In summary, TH should be offered to newborn infants born ≥36. weeks gestational age and birth weight ≥1800. g exhibiting clinical signs of moderate to severe NE as well as evidence of hypoxia-ischemia, i.e. 10 min Apgar score ≤5, a need for resuscitation at 10. min, blood pH < 7.00, or base deficit ≥16. mmol/L. TH should be conducted in the NICUs capable of multidisciplinary care and under the standard protocols, i.e. utilization of cooling device, target (rectal or esophageal) temperatures at 33.5 ± 0.5 and 34.5 ± 0.5 °C for whole body and selective head cooling respectively, duration of TH for 72. h, gradual rewarming not exceeding the rate of 0.5 °C/h. Long term follow-up with multidisciplinary approach including standardized psychological assessment is warranted.
KW - Neonatal encephalopathy
KW - Therapeutic hypothermia
UR - http://www.scopus.com/inward/record.url?scp=84855584423&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855584423&partnerID=8YFLogxK
U2 - 10.1016/j.braindev.2011.06.009
DO - 10.1016/j.braindev.2011.06.009
M3 - Comment/debate
C2 - 21930356
AN - SCOPUS:84855584423
SN - 0387-7604
VL - 34
SP - 165
EP - 170
JO - Brain and Development
JF - Brain and Development
IS - 2
ER -