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Therapeutic Hypothermia in Transport Permits Earlier Treatment Regardless of Transfer Distance. Am J Perinatol 2022 Apr;39(6):633-639



Pubmed ID




Scopus ID

2-s2.0-85094114197 (requires institutional sign-in at Scopus site)   2 Citations


OBJECTIVE: Therapeutic hypothermia (TH) is currently the only effective therapy available to improve outcomes in neonates with hypoxic-ischemic encephalopathy (HIE) and has maximal effect when initiated within 6 hours of birth. Neonates affected by HIE are commonly born outside of cooling centers and transport is a barrier to timely initiation. In this study, we sought to determine if the initiation of servo-controlled TH in transport allowed neonates to reach target temperature earlier, without a significant delay in the transfer process, for both local and long-distance transport.

STUDY DESIGN: In this single-center cohort study of neonates referred to a level IV neonatal intensive care unit for TH, we determined the chronologic age at which target temperature was reached for those cooled in transport. Short-term outcome measures were assessed, including survival, incidence of electrographic seizures, discharge feeding method, and length of hospitalization.

RESULTS: In a study population of 85 neonates, those receiving TH during transport (n = 23), achieved target temperature (33-34°C) 77 minutes sooner (230 ± 71 vs. 307 ± 79 minutes of life (MOL); p < 0.001). Locally transported neonates (<15 miles) achieved target temperature 69 minutes earlier (215 ± 48 vs. 284 ± 74 MOL; p < 0.01). TH during long-distance transports allowed neonates to reach target temperature 81 minutes sooner (213 ± 85 vs. 294 ± 79 MOL; p < 0.01). Infants who were cooled in transport discharged 4 days earlier (13.7 ± 8 vs. 17.8 ± 13 days; p = 0.18) and showed a significantly higher rate of oral feeding at discharge (95 vs. 71%; p = 0.03).

CONCLUSION: For those starting TH in transport, time to target temperature was decreased. In our cohort, cooling in transport was associated with improved short-term outcomes, although additional studies are needed to correlate these findings with long-term outcomes.

KEY POINTS: · Therapeutic hypothermia started during transport allows shorter time to target temperature.. · Transfer was minimally delayed by starting cooling in transport.. · Cooling in transport was associated with increased rate of oral feeding at hospital discharge..

Author List

Leon RL, Krause KE, Sides RS, Koch MB, Trautman MS, Mietzsch U


Katherine E. Krause MD Adjunct Instructor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cohort Studies
Hypothermia, Induced
Hypoxia-Ischemia, Brain
Infant, Newborn
Intensive Care Units, Neonatal
Patient Transfer