463 - Latin American ALSEPNEO´s survey on Therapeutic and Follow-up resources for Hypoxic-Ischaemic Encephalopathy across 16 countries.

Publication Number: 4454.463

Lidia B. Giudici, University of Buenos Aires- Medicine College- ALSEPNEO, CABA, Buenos Aires, Argentina; Alejandro Maccarrone, Universidad Nacional de Rosario Facultad de Ciencias Medicas, Rosario, Santa Fe, Argentina; César Sánchez, Sanatorio Florencia, Zinacantepec, Estado de México, Mexico; René H. Barrera, Instituto Nacional de Perinatología, Ciudad de México, Ciudad de México, Estado de México, Mexico; Mónica i. Morgues, ALSEPNEO, Santiago, Region Metropolitana, Chile

Background: Available resources to provide gold standard support for hypoxic-ischemic encephalopathy (HIE) in the neonatal period, and the Follow-up in the ambulatory setting, have not been assessed across Latin American countries.

Objective: To assess available resources for therapy and follow-up of neonates with HIE, across Latin America, through a semi-estructured survey.designed by ALSEPNEO

Design/Methods: A survey was designed by ALSEPNEO, in Google form (https://docs.google.com/forms/ - Google® for staff members of healthcare teams in Latin America caring for newborn with HIE. Questions included: 1) first minutes care (members of staff trained or not); 2) Access to recommended monitoring; 3) Timely transport; 4) Cooling and other neuroprotective measures; 5) Images; 6) Access to Interdisciplinary Follow-up after Hospital discharge, with timely interventions. Distributed via ALSEPNEO´s network during four weeks. Analyses: STATA 12.1 (Stata Statistical Software, Version 12.0 [Computer Software]. College Station, TX: StataCorp LP, 2011).

Results: 196 answers received (from 16 countries): 72% level III and 24 %, level II neonatal units. Units in the three levels had therapeutic hypothermia (TH) (61%): 10% level II neonatal units and 50% in level III neonatal units. No significant differences between public and private healthcare institutions. Neuromonitoring: 57% of reporting centres; 55% of level III and 6% of level II neonatal units. Neuroimaging: 87% (89% level III, 81 % level II neonatal units, and 87% in Level I neonatal units). Fifty eight percent of responders were able to refer to a centre with TH prior to 6 hours of life. Neuroptrotective medication: 9% of responding centres reported use, mostly Eritropoietin . Interdisciplinary Follow-up: 49% provided rehab therapies and Follow-up; 74% of them with specialized staff.

Conclusion(s): Appropriate coverage for TH in neonates with HIE is lacking in Latin America, with an important number of neonatal units not even getting timely transport and referral for their patients. This survey gave us the opportunity to maintain a surveillance on this issue. As a first step to improve the standards of care in our region, we published an interdisciplinary guideline for the management and follow- up of babies with HIE in Latin America, specially designed for low-resource settings. This Guideline is open to all neonatal and pediatric health care professionals in our region