Cool and transfer – The way forward

ObjectiveEvaluation of servo-controlled cooling by a Neonatal Transport Service and comparison to patients where active cooling was initiated by a pilot Local Neonatal Unit (LNU).DesignService evaluation of 3 groups of babies referred to a single Neonatal Transport Service between 2009 and 2013. Age of initiation of active cooling, achievement of the target temperature and temperature stability in a group of patients where active cooling was commenced by the transport team was compared to cases where passive cooling only was possible. In addition, we evaluated the effectiveness and safety of active cooling initiation in a single LNU.ResultsActive cooling initiation by the transport service at the local hospital led to earlier commencement of cooling compared to passive cooling transfers. However, one fifth of this cohort failed to start active cooling by 6 h of age. In a series of 7 cases where active cooling was commenced by the referring LNU prior to transfer, the target temperature was achieved around 2 h earlier and all infants were cooled within 6 h of age. No adverse incidents occurred within this group.ConclusionActive servo-controlled cooling during transfer is an effective and safe treatment that should now be considered the “Gold Standard” for Neonatal Transport Services. Even with this ability, a significant number of neonates will not be cooled in a timely manner. Initiation of servo-controlled, active cooling by the local referring unit prior to transfer to a recognised cooling centre, may ensure that infants receive this neuro-protective treatment at an earlier stage.