LOW-TECH TOTAL THERAPEUTIC HYPOTHERMIA IN NEWBORN WITH SEVERE HYPOXIC-ISCHEMIC ENCEPHALOPATHY AT STAGES REFERRAL HOSPITAL, TRANSPORT AND COOLING CENTER. GUIDELINE
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Abstract
Severe neonatal hypoxic-ischemic encephalopathy is one of the most important health and social problems due to the high morbidity and mortality in this group of children. The only method that can reduce the risk of adverse outcomes, a moderate total therapeutic hypothermia (TTG) is achieved by using a specialized cooling equipment (high-tech), or the use of simple means of cooling, such as ambient temperature and water packets (low-tech). The effectiveness of this technique has only provided it is an early start (within 6 hours of birth), duration of not less than 72 hours, subject to strict temperature range 33,0-34,0°C, as well as the full volume of resuscitation and intensive care of the newborn. If newborn requiring TTG born outside third-level hospital, it is necessary to start at the stage of the referral hospital, with subsequent transport as soon as possible at the cooling center. These guidelines describe how to identify patients in need of TTG, the sequence of TTG on stages of the referral hospital, transport and cooling center, as well as issues of intensive care and laboratory examination of this group of patients.
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