Interdisciplinary clinical protocol of therapeutic hypothermia for newborns with asphyxia: implementation research
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Keywords

Protocolos Clínicos
Hipotermia Induzida
Ciência da Implementação
Asfixia
Recém-Nascido
Enfermagem Neonatal Clinical protocols
Induced Hypothermia
Implementation Science
Asphyxia
Newborn
Neonatal Nursing

PlumX Metrics

Abstract

Objective: To describe the process of implementing an interdisciplinary protocol for the management of therapeutic hypothermia. Method: Implementation research with a participatory approach, which used the Consolidated Reference Framework for Implementation Science for the elaboration and implementation of the protocol, carried out in the Neonatal Intensive Care Unit of a university hospital in southeastern Brazil, with the participation of the interprofessional team and managers. Results: The first protocol for therapeutic hypothermia was developed and implemented in the institution. Training was carried out that improved the team knowledge. Flowcharts and infographics were designed to direct interprofessional work in this process and translate knowledge to the user population. Conclusion: The interdisciplinary protocol for the management of therapeutic hypothermia was built in a participatory way by the team. The training in cycles involving the different professionals brought great interaction between them and engagement to achieve improvements, with exchange of experiences and increased knowledge about therapeutic hypothermia.

https://doi.org/10.17665/1676-4285.20246774
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References

Word Health Organization. Newborn mortality [Internet]. Genebra (CH): Word Health Organization; 2021 [citado 2024 Mar 23]. Disponível em: https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-mortality-report-2021

Moshiro R, Mdoe P and Perlman JM. A global view of neonatal asphyxia and resuscitation. Front Pediatr. 2019;7:489. https://doi.org/10.3389/fped.2019.00489

Thayyil S, Pant S, Montaldo P, Shukla D, Oliveira V, et al. Hypothermia for moderate or severe neonatal encephalopathy in low-income and middle-income countries (HELIX): a randomized controlled trial in India, Sri Lanka, and Bangladesh. Lancet Glob Health. 2021;9(9):e1273–85. https://doi.org/10.1016/S2214-109X(21)00264-3

Abate BB, Bimerew M, Gebremichael B, Mengesha Kassie A, Kassaw M, Gebremeskel T, et al. Effects of therapeutic hypothermia on death among asphyxiated neonates with hypoxic-ischemic encephalopathy: a systematic review and meta-analysis of randomized control trials. PLoS One. 2021;16(2):e0247229. https://doi.org/10.1371/journal.pone.0247229

Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas. Atenção à saúde do recém-nascido: guia para os profissionais de saúde [Internet]. Brasília: Ministério da Saúde; 2014 [citado 2024 Mar 23]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/atencao_saude_recem_nascido_v1.pdf

Victor S, Rocha-Ferreira E, Rahim A, Hagberg H, Edwards D. New possibilities for neuroprotection in neonatal hypoxic-ischemic encephalopathy. Eur J Pediatr. 2022;181(3):875–87. https://doi.org/10.1007/s00431-021-04320-8

Walas W, Wilińska M, Bekiesińska-Figatowska M, Halaba Z, Śmigiel R. Methods for assessing the severity of perinatal asphyxia and early prognostic tools in neonates with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia. Adv Clin Exp Med. 2020;29(8):1011-1016. https://pubmed.ncbi.nlm.nih.gov/32820870

Danladi J, Sabir H. Perinatal Infection: A Major Contributor to Efficacy of Cooling in Newborns Following Birth Asphyxia. Int J Mol Sci. 2021;22(2):707. https://doi.org/10.3390/ijms22020707

Nakwa FL, Sepeng L, van Kwawegen A, Thomas R, Seake K, Mogajane T, et al. Characteristics and outcomes of neonates with intrapartum asphyxia managed with therapeutic hypothermia in a public tertiary hospital in South Africa. BMC Pediatr. 2023;23(1):51. https://doi.org/10.1186/s12887-023-03852-2

Roychoudhury S, Esser MJ, Buchhalter J, Bello-Espinosa L, Zein H, Howlett A, et al. Implementation of neonatal neurocritical care program improved short-term outcomes in neonates with moderate-to-severe hypoxic ischemic encephalopathy. Pediatr Neurol. 2019;101:64-70. https://doi.org/10.1016/j.pediatrneurol.2019.02.023

Variane GF, Cunha LM, Pinto P, Brandao P, Mascaretti RS, Magalhães M, Sant'Anna GM. Therapeutic Hypothermia in Brazil: A MultiProfessional National Survey. Am J Perinatol. 2019;36(11):1150-1156. https://doi.org/10.1055/s-0038-1676052

Arnaez J, Herranz-Rubia N, Garcia-Alix A, Grupo de Trabajo ESP-EHI. Unidades de Neonatología. Hospitales terciarios, España. Holistic approach of the care of the infant with hypoxic-ischaemic encephalopathy in Spain. An Pediatr (Engl Ed). 2020;92(5):286-296. https://doi.org/10.1016/j.anpedi.2019.05.013

Sociedade Brasileira de Pediatria. Hipotermia Terapêutica [Internet]. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2020 [citado 2024 Mar 23]. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/22568c-DocCient_-_Hipotermia_Terapeutica.pdf

Sociedade Brasileira de Pediatria. Monitoramento do recém-nascido com asfixia perinatal [Internet]. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2020 [citado 2024 Mar 23]. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/22631c-MO-_Monitoram_do_RN_c_asfixia_perinatal.pdf

Sociedade Brasileira de Pediatria. Reanimação do recém-nascido ≥34 semanas em sala de parto: Diretrizes da Sociedade Brasileira de Pediatria [Internet]. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2022 [citado 2024 Mar 23]. Disponível em: https://portaldeboaspraticas.iff.fiocruz.br/biblioteca/reanimacao-do-recem-nascido-%E2%89%A534-semanas-em-sala-de-parto-diretrizes-2016-da-sbp/

Fundação Oswaldo Cruz (BR); Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Postagens: Hipotermia Terapêutica [Internet]. Rio de Janeiro: Fundação Oswaldo Cruz; 2018 [citado 2023 Nov 10]. Disponível em: https://portaldeboaspraticas.iff.fiocruz.br/atencao-recem-nascido/hipotermia-terapeutica/

Protecting Brains & Saving Futures. Protocolo de hipotermia [Internet]. São Paulo: Protecting Brains & Saving Futures; 2023 [citado 2023 Nov 23]. Disponível em: https://pbsf.com.br/para-profissionais/

Royal Children’s Hospital Melbourne. Therapeutic hypothermia in the neonate [Internet]. [The Royal Children's Hospital Melbourne (AU)]: Nursing Clinical Effectiveness Committee; 2023 [citado 2023 Nov 12]. Disponível em: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Therapeutic_hypothermia_in_the_neonate/

Prashantha YN, Suman Rao PN, Nesargi S, Chandrakala BS, Balla KC, Shashidhar A. Therapeutic hypothermia for moderate and severe hypoxic ischaemic encephalopathy in newborns using low-cost devices - ice packs and phase changing material. Paediatr Int Child Health. 2019;39(4):234-239. https://doi.org/10.1080/20469047.2018.1500805

Oliveira NRGd, Teixeira GG, Fernandes KTMS, Avelar MM, Medeiros M, Formiga CKMR. Therapeutic hypothermia as a neuroprotective strategy in newborns with perinatal asphyxia - case report. Front Rehabil Sci. 2023;4:1132779. https://doi.org/10.3389/fresc.2023.1132779

Leite PNM, Teixeira RB, Silva GD da, Reis AT, Araujo M. Therapeutic hypothermia in neonatal hypoxic-ischemic encephalopathy: integrative review. Rev enferm UERJ [Internet]. 2020 [citado 2023 Nov 12];28:e42281. Disponível em: https://www.e-publicacoes.uerj.br/enfermagemuerj/article/view/42281

Kinoshita AN, Magalhães M, Rodrigues DP, Variane GFT, Pietrobom RFR, Gallaci CB, et al. Effectiveness of reaching and maintaining therapeutic hypothermia target temperature using low-cost devices in newborns with hypoxic-ischemic encephalopathy. Anat Rec (Hoboken). 2021;304(6):1217-1223. https://doi.org/10.1002/ar.24615

Bueno M, Vieira ACG, Bacchini F. Integration of the family to neonatal care: new care perspectives. Online Braz J Nurs. 2023;22:e20236634. https://doi.org/10.17665/1676-4285.20236634

Cunha CMC, Lima EFA, Galvão DMPG, Brito APA, Fonseca LMM, Primo CC. Breastfeeding assistance for preterm and low birth weight infants: best practices implementation project. Rev Esc Enferm USP. 2024;58:e20230380. https://doi.org/10.1590/1980-220X-REEUSP-2023-0380en

Bauer MS, Kirchner J. Implementation science: What is it and why should I care? Psychiatry Res. 2020;283:112376. https://doi.org/10.1016/j.psychres.2019.04.025

Silva ESD, Primo CC, Gimbel S, Almeida MVS, Oliveira NS, Lima EFA. Elaboration and implementation of a protocol for the Golden Hour of premature newborns using an Implementation Science lens. Rev Lat Am Enfermagem. 2023;31:e3956. https://doi.org/10.1590/1518-8345.6627.3956

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