Therapeutic Hypothermia, or Cooling Therapy, for Hypoxic-Ischemic Encephalopathy (HIE)
Research shows that when a brain injury such as hypoxic-ischemic encephalopathy (HIE) occurs at or near the time of birth, therapeutic hypothermia (or cooling therapy) can help to reduce the devastating nature of the injury. The severity of HIE ranges from mild to severe. Depending on the severity, HIE can cause major difficulties for a child, including seizures, cognitive defects, developmental delays, and many other issues. When a child is diagnosed with HIE, there is an increased likelihood of also being diagnosed with cerebral palsy (CP) later in life.
How Does Cooling Therapy Work?
Cooling therapy helps to protect the baby’s brain from further injury by decreasing blood flow to the injury, thus reducing the swelling. This is done by reducing the baby’s temperature to 34.5 to 35 degrees Celsius (94.1 to 95 degrees Fahrenheit) for selective head cooling, or 33.5 to 34 degrees Celsius (92.3 to 93.2 degrees Fahrenheit) for whole-body cooling. The baby is cooled for a maximum of 72 hours, then slowly rewarmed to 37 degrees Celsius (98.6 degrees Fahrenheit).
Some studies suggest that whole-body cooling is more effective than selective head cooling, but both can be used to help reduce further damage to a baby’s brain after a hypoxic-ischemic brain injury has occurred.
When is Cooling Therapy Used?
There are criteria that are used to determine if an injured baby is eligible for cooling therapy, which varies from one hospital to another.
Cooling therapy criteria often include the following:
- At least 36 weeks gestational age or greater
- A blood cord pH of less than or equal to 7.0 or base deficit of 10 or greater
- A 10-minute APGAR score of less than 5
- Assisted ventilation at birth that continued for at least 10 minutes
- A neurological exam indicating moderate to severe encephalopathy (brain disease, damage, or malfunction)
- An abnormal EEG (or aEEG)
- Evidence of organ-system dysfunction, like decreased urine output, elevated creatinine or elevated liver function enzymes
The Effects of Cooling Therapy
Cooling therapy becomes less and less effective the longer the delay in treatment. When administered within 6-12 hours of the injury, cooling therapy can decrease the severity of disability for the child later in life.
According to scientific research studies, the MRI’s of babies who’ve undergone cooling therapy within 6-12 hours of birth often have less grey matter abnormalities, or lesions, than babies born with HIE who were not treated with cooling therapy. Grey matter is important because it includes the regions of the brain involved with muscle control and sensory perception, such as seeing, hearing, memory, emotions, speech, decision making, and self-control.
If your child has a brain injury such as hypoxic-ischemic encephalopathy from negligence at or near birth, please give us a call to see how we can help. Our team of lawyers who are also doctors have over thirty years of experience helping families affected by birth injuries such as HIE and cerebral palsy.
To schedule a free consultation with our legal team, complete our contact form or call (816) 253-8606.