164 - CUBS (Cooling Under Blanketrol System) vs CATS (Cooling with Arctic sun Thermoregulation System) for Therapeutic Hypothermia in the NICU

Poster Number: 164
Publication Number: 164.233

Muppala Raju, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; William T. Richardson, Baylor Scott White McLane Children's Medical Center, Georgetown, TX, United States; Ineshia Jackson, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Tara Lyngaas, Baylor Scott White McLane Children's Medical Center, Georgetown, TX, United States; Venkata Raju, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Niraj Vora, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Madhava Beeram, Texas A&M Health Science Center College of Medicine, Temple, TX, United States; Mahmoud Ali, MetroHealth Medical center/Case Western Reserve university, North olmsted, OH, United States; Vinayak Govande, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States

Background: While therapeutic hypothermia is associated with improved outcomes in infants with neonatal encephalopathy, limited data exists on temperature variability during all phases of cooling and clinical outcomes. We performed a cohort study to compare two commonly used cooling systems in Neonatal Intensive Care Units (NICUs) in the United States.

Objective: To compare the temperature variability and clinical outcomes of infants receiving therapeutic hypothermia using the Arctic Sun cooling system with infants treated with Blanketrol III device

Design/Methods: A cohort study was conducted at Baylor Scott and White McLane Children’s Medical Centers level IV NICU. Arctic sun device was used for therapeutic hypothermia from December 2020 to August 2021. This data was compared with infants cooled using the Blanketrol system from January 2017 to November 2020. The clinical characteristics, outcomes and the ease of use of machines through a survey sent to the NICU nurses, were studied. Temperatures were documented at 4-hour intervals. This included temperatures during the induction, maintenance and re-warming phases

Results: Twenty-two infants were cooled using the Arctic sun system and 44 infants with the Blanketrol device. Median Birth weight of infants were 3.04 kg and 3.24 kg; with median Gestational age of 38.3 weeks and 39.1 weeks, respectively in the two groups (Arctic sun vs Blanketrol). There were no significant differences in the APGAR scores at 1 min and 5 mins. There were significantly greater maternal morbidities including diabetes and placental abruption in the Arctic sun group. Temperature variability was statistically significant between the two devices, median temperature was 33.5 °C on both devices but greater variability was observed with Blanketrol device (p=0.03). Statistically significant differences were noted in the rates of Thrombocytopenia (9% in Arctic sun system vs 38% in Blanketrol device, p=0.001). More infants had disseminated intravascular coagulation (48% vs 37%), hypercalcemia (23% vs 5%) and subacute fat necrosis (7% vs 5%) in the Blanketrol group, but were not statistically significant. The nurses’ survey on ease of use showed a greater preference for Arctic sun cooling system, with > 85 % preferring it for ease of learning, device set up and requiring lesser manual interventionConclusion(s): Arctic Sun cooling system had lower variability in temperatures during all phases of therapeutic hypothermia. Lower hypothermia related complications were observed in the Arctic sun group. Arctic Sun system was greatly preferred over Blanketrol device by NICU nurses for overall ease of use
Table 1: Subject demographics
Table 2: Differences in temperature variability and associated known cooling related complications