Recorded sessions on demand will be available 24 hours after the session ends

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Background: Therapeutic hypothermia (TH) is the only intervention shown to improve outcomes in Neonatal Encephalopathy (NE). In our region TH provision is limited to 4 tertiary neonatal centres. TH should begin within 6 hours of birth, and this can pose logistical problems for infants born in our 15 regional centres, some >3 hours by road from a TH centre. In 2013, we reviewed our national guideline on passive cooling to initiate TH and added a TH candidacy checklist. In conjunction with the introduction of servo-controlled active TH in transport in 2017, NNTP spearheaded an enhanced TH model of care.

Aim: This audit aimed to assess the efficacy of the enhanced model of care and identify areas for improvement.

Methods: This was a retrospective review of NNTP records over an 18-month period, following full guideline implementation in 2017. Results were compared to a similar audit undertaken in 2014 (n=30).

Results: 30 babies were transported by NNTP from 13 non-tertiary centres to the four TH centres over the period.

Conclusions: The new model of peri-transport TH care has been adopted by all regional units, fostering a culture of collaboration between referring and TH units, and facilitating a seamless continuum of patient care. This is evidenced in the further improvement of target temperature achievement times across the region.

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BACKGROUND: Despite advances in perinatal medicine, nearly 40 per cent of all childhood deaths occur in the first four weeks of life, making neonates the largest subgroup. While many recommendations advise what health care professionals (HCPs) should do, there is little data on how HCPs and parents actually proceed in the practice of perinatal palliative care (PPC).

OBJECTIVE: It is, therefore, the goal of this systematic review to assess the needs of parents and HPCs in the context of PPC.

METHODS: A systematic search of the literature concerning needs of parents and HCPs in perinatal palliative care was conducted in five databases (Medline, Embase, Cochrane Library, CINAHL, Scopus). The search strategy identified 8143 potentially relevant articles, of which 90 have been included in the current review. Studies applying both quantitative and qualitative approaches have been included in the review and data were analyzed through narrative synthesis. The protocol of the current review was registered on the PROSPERO database (Registration number: CRD42020171461).

RESULTS: This systematic review will provide a preliminary overview of the needs of parents and HCPs in the context of PPC.

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Background: Very low birth weight (VLBW) infants constitute a high-risk population for morbidity and mortality in the neonatal period. Variability in practices and outcomes between centres has been acknowledged. Multi-centre benchmarking studies are useful to detect areas of improvement and constitute an interesting research tool.

Objectives: To assess the perinatal variables and interventions associated with survival and survival without major morbidity in VLBW infants and compare the performance of two big networks.

Methods: Retrospective analysis of data prospectively collected in two databases, SEN1500 and Neocosur, from 2013 to 2016. Inborn patients, from 24⁰ to 30⁶ weeks’ gestational age (GA) were included. Survival and survival without major morbidity were studied by the Cox proportional hazards regression method, adjusted for confounders.

Results: A total of 10,568 patients, 6,120 (57.9%) from SEN1500 and 4,448 (42.1%) from NEOCOSUR, were included. In addition to GA, birth weight, female sex, antenatal steroids, and gentle resuscitation, the network of origin was a significant independent factor influencing survival and survival without major morbidity [SEN1500 vs Neocosur: aHR 1.296 (95 %CI: 1.006 – 1.671); p=0.045].

Conclusions: After adjusting for confounders, the network of origin showed an independent effect on outcomes. This finding may be due to differences in resources and practices, but also to other factors no yet determined. Large multinational collaborative networks allow the obtention of information in shorter periods of time. However, this information has to be managed carefully and, in order to offset the effect of inter-centre variability, the results could require to be adjusted for this factor.