Hypothermic treatment for neonatal asphyxia in low-resource settings using phase-changing material-An easy to use and low-cost method

Aim To evaluate whether phase-changing material can be used for therapeutic hypothermia of asphyxiated newborns in low-resource settings. Methods Prospective interventional study of asphyxiated term infants fulfilling criteria for hypothermia treatment at Vietnam National Children's Hospital from September 2014 to September 2016. Hypothermia was induced within 6 hours after birth and maintained for 72 hours by a phase-changing material mattress with melting point of 32 degrees C. Rectal temperature was continuously measured, and deviations from target temperature range 33.5-34.5 degrees C were recorded. Results In total 52 infants (mean gestational age 39.3 +/- 1.1 weeks) included and cooled, the median temperature at initiation of cooling was 35.3 (IQR 34.5-35.9)degrees C. The median time to reach target temperature was 2.5 (IQR 2-3) hours. The mean temperature during the cooling phase was 33.95 +/- 0.2 degrees C. Throughout the cooling phase, the target temperature range (33.5-34.5 degrees C) was maintained more than 80% of the time. Rate of rewarming was 0.5 +/- 0.14 degrees C/hour. Conclusion Phase-changing material can be used as an effective cooling method. Though not a servo-controlled system, it is easy to induce hypothermia, maintain target temperature and rewarm infants in a slow and controlled manner without need for frequent changes and minimum risk of skin injury.

Automated summary

The study demonstrates that phase-changing material can be an effective method for cooling asphyxiated newborns, maintaining target temperature range and rewarming infants in a slow and controlled manner, with easy operation and minimal risks.