A quantitative analysis of optimal treatment capacity for perinatal asphyxia.
Med Decis Making
; 32(2): 266-72, 2012.
Article
en En
| MEDLINE
| ID: mdl-21933991
OBJECTIVE: In centers electing to offer therapeutic hypothermia for treating hypoxic-ischemic encephalopathy (HIE), determining the optimal number of cooling devices is not straightforward. The authors used computer-based modeling to determine the level of service as a function of local HIE caseload and number of cooling devices available. METHODS: The authors used discrete event simulation to create a model that varied the number of HIE cases and number of cooling devices available. Outcomes of interest were percentage of HIE-affected infants not cooled, number of infants not cooled, and percentage of time that all cooling devices were in use. RESULTS: With 1 cooling device, even the smallest perinatal center did not achieve a cooling rate of 99% of eligible infants. In contrast, 2 devices ensured 99% service in centers treating as many as 20 infants annually. In centers averaging no more than 1 HIE infant monthly, the addition of a third cooling device did not result in a substantial reduction in the number of infants who would not be cooled. CONCLUSION: Centers electing to offer therapeutic hypothermia with only a single cooling device are at significant risk of being unable to provide treatment to eligible infants, whereas 2 devices appear to suffice for most institutions treating as many as 20 annual HIE cases. Three devices would rarely be needed given current caseloads seen at individual institutions. The quantitative nature of this analysis allows decision makers to determine the number of devices necessary to ensure adequate availability of therapeutic hypothermia given the HIE caseload of a particular institution.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Asfixia Neonatal
/
Simulación por Computador
/
Unidades de Cuidado Intensivo Neonatal
/
Hipoxia-Isquemia Encefálica
/
Estudios de Evaluación como Asunto
/
Necesidades y Demandas de Servicios de Salud
/
Hipotermia Inducida
Tipo de estudio:
Diagnostic_studies
/
Evaluation_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Decis Making
Año:
2012
Tipo del documento:
Article
Pais de publicación:
Estados Unidos