Therapeutic hypothermia for neonatal encephalopathy: 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)

Toshiki Takenouchi, Osuke Iwata, Makoto Nabetani, Masanori Tamura

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29 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)165-170
Number of pages6
JournalBrain and Development
Volume34
Issue number2
DOIs
Publication statusPublished - 2012 Feb

Fingerprint

Induced Hypothermia
Group Practice
Brain Diseases
Practice Guidelines
Japan
Medicine
Health
Standard of Care
Resuscitation
Clinical Trials
Rewarming
Apgar Score
Asphyxia
Birth Weight
Gestational Age
Ischemia
Head
Newborn Infant
Psychology
Equipment and Supplies

Keywords

  • Neonatal encephalopathy
  • Therapeutic hypothermia

ASJC Scopus subject areas

  • Clinical Neurology
  • Developmental Neuroscience
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Therapeutic hypothermia for neonatal encephalopathy: 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)",
abstract = "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.",
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