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Updated: Oct 27, 2025
A Swine Model of Neonatal Asphyxia
Published on: October 11, 2011
Process variations between Swiss units treating neonates with hypoxic-ischemic encephalopathy and their effect on
Mark Adams1, Barbara Brotschi2, André Birkenmaier3
1Newborn Research, Department of Neonatology, University and University Hospital Zurich, Zurich, Switzerland. mark.adams@usz.ch.
Objective:
To compare therapeutic hypothermia (TH) treatment of term and near-term neonates with hypoxic-ischemic encephalopathy (HIE) between neonatal units.
Study Design:
Population-based, retrospective analysis of TH initiation and maintenance, and of diagnostic imaging. The comparison between units was based on crude data analysis, indirect standardization, and adjusted logistic regression.
Results:
TH was provided to 570 neonates with HIE between 2011 and 2018 in 10 Swiss units. We excluded 121 off-protocol cooled neonates to avoid selection bias. Of the remaining 449 neonates, the outcome was favorable to international benchmarks, but there were large unit-to-unit variations in baseline perinatal data and TH management. A total of 5% neonates did not reach target temperature within 7 h (3-10% between units), and 29% experienced over- or undercooling (0-38%).
Conclusion:
Although the neonates had favorable short-term outcomes, areas for improvement remain for Swiss units in both process and outcome measures.
