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An Pediatr (Barc). 2015 Mar;82(3):172-82. doi: 10.1016/j.anpedi.2014.05.006. Epub 2014 Jun 21.

[Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)].

[Article in Spanish]

Author information

1
Unidad de Neonatología, Hospital Universitario de Burgos, Burgos, España. Electronic address: jusoru@hotmail.com.
2
Unidad de Neonatología, Hospital Universitario de Burgos, Burgos, España.
3
Unidad de Neonatología, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, España.
4
Unidad de Neonatología, Hospital Universitario de Salamanca, Salamanca, España.
5
Unidad de Neonatología, Hospital Universitario Río Hortega, Valladolid, España.
6
Unidad de Neonatología, Hospital Nuestra Señora de Sonsoles, Ávila, España.
7
Unidad de Neonatología, Hospital Universitario de León, León, España.
8
Unidad de Neonatología, Hospital San Pedro de Logroño, Logroño, España.
9
Unidad de Neonatología, Hospital General de Segovia, Segovia, España.
10
Unidad de Neonatología, Hospital General de Zamora, Zamora, España.
11
Unidad de Neonatología, Hospital Santa Bárbara, Soria, España.
12
Unidad de Neonatología, Hospital El Bierzo, Ponferrada, León, España.
13
Servicio de Pediatría, Hospital Santiago Apóstol, Miranda de Ebro, Burgos, España.
14
Servicio de Pediatría, Hospital Santos Reyes, Aranda de Duero, Burgos, España.

Abstract

INTRODUCTION:

Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment.

PATIENTS AND METHODS:

The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m(2)); two level i centers, five level ii centers, and five level iii hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport.

RESULTS:

From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%).

CONCLUSIONS:

The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy.

KEYWORDS:

Asfixia perinatal; Clinical pathway; Encefalopatía hipóxico-isquémica; Hypoxic-ischemic encephalopathy; Perinatalasphyxia; Program; Programa; Vía clínica

PMID:
24957564
DOI:
10.1016/j.anpedi.2014.05.006
[Indexed for MEDLINE]
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