Time = Brain
Time=Brain is a regional Neonatal Therapeutic Hypothermia project devised and led by Dr. Peter Reynolds and supported by South East Neonatal Network and the Maternity, Children & Young People’s Strategic Clinical Network.
The South East Neonatal Network (SENN) Time=Brain project aims to enhance the protection of babies’ brains when there is evidence of moderate or severe encephalopathy through optimising the use of therapeutic hypothermia (cooling).
There are four key aims to this project:
- To ensure that the decision to cool babies is consistently applied across the SEC region
- To achieve the target temperature range safely & promptly, avoiding under- or over- cooling
- To achieve the target temperature (33-34°C) within 6 hours of birth (or postnatal collapse event)
- To maintain the target temperature during handover and transport of babies
The key message for Time=Brain is that there is sufficient time to examine and document the baby’s neurology, diagnose the Grade of Encephalopathy and start servo-controlled cooling for moderate and severe grades, to reach the target temperature within 6 hours of birth according to NICE Guidelines.
NICHD Scoring for HIE
The NICHD chart (downloadable/printable below) should be used to guide clinicians as to when to commence cooling. This replaces the previously used Thompson/BadgerNet scoring. The criteria for babies being at particular risk of HIE has not changed. We continue to encourage clinicians to take time to evaluate the baby on the neonatal unit, with repeated clinical examinations, use of CFM where available, and discussion with a senior clinician at the local NICU, before initiation of cooling. Starting cooling on delivery suite is not recommended.
In line with current NICE guidance, we aim for babies to be at the target temperature of 33-34 degrees C. The use of servo-controlled cooling devices will normally achieve this within an hour of commencing cooling.
TimeBrain NICHD Chart