Management of hypothermia for perinatal asphyxia in Austria - a survey of current practice standards

Therapeutic hypothermia (HT) has been shown to reduce the risk of death or disability and increase the rate of survival free of -disability at 18-24 months of age in hypoxic-ischemic encephalopathy (HIE).

The aim of this study was to take a national survey which (a) evaluated the practice of therapeutic HT for perinatal asphyxia in Austria, (b) evaluated the current clinical management of neonatal HIE and (c) evaluated the need for a national perinatal asphyxia and HT registry.

In January 2013, a questionnaire was sent out to the clinical heads of all neonatal level-II and level-III units in Austria.

We received replies from all 30 level II and level III units in Austria (response rate 100%). 19 units (63%) answered that they applied HT, 11 units (37%) said they transferred patients for cooling to other units, 3 of those 11 units (27%) said they applied cooling during transport. 25 units (83%) felt the necessity to establish a national registry.

The results of this survey show that there is already a high implementation of therapeutic HT in Austria, but there remains a need for information, awareness and training. Problem areas tend to be in the transport of asphyxiated neonates, brain monitoring during cooling and follow-up of affected patients. We believe, that the establishment of national guidelines and a national register could increase awareness for the importance of therapeutic HT in neonatal HIE, thus improve the Austrian management of those infants.