Fifteen-minute consultation: Therapeutic hypothermia for infants with hypoxic ischaemic encephalopathy-translating jargon, prognosis and uncertainty for parents

Arch Dis Child Educ Pract Ed. 2020 Apr;105(2):75-83. doi: 10.1136/archdischild-2017-314116. Epub 2019 Jul 10.

Abstract

Hypoxic ischaemic encephalopathy may lead to death or severe long-term morbidity. Therapeutic hypothermia (TH) increases survival without impairments in childhood, but prognostic uncertainty may remain for years after birth. Clear and accurate communication is imperative but challenging. This article explores the predictive value of routinely performed assessments during TH, as well as the qualitative research relating to parental experience. This article will benefit paediatric trainees, consultants and nurse practitioners in providing: (1) the background information needed for initiating a conversation with parents regarding outcome and (2) optimising their communication with parents in translating jargon, prognosis and uncertainty.

Keywords: breaking bad news; communication; hypoxic ischaemic encephalopathy; prognosis; therapeutic hypothermia.

MeSH terms

  • Apgar Score
  • Child
  • Child, Preschool
  • Humans
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain / complications
  • Hypoxia-Ischemia, Brain / mortality
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant
  • Infant, Newborn
  • Neurodevelopmental Disorders / diagnosis*
  • Neurodevelopmental Disorders / epidemiology*
  • Parents / psychology*
  • Predictive Value of Tests
  • Prognosis
  • Referral and Consultation*
  • Uncertainty