There is a treatment for hypoxic-ischemic encephalopathy (HIE) that can help prevent the baby from having long-term problems, but it has to be given within six hours of the brain insult, which usually means the baby has to be diagnosed with HIE and given treatment within six hours of delivery. This treatment is called hypothermia treatment (brain cooling).
How Can Hypothermia Therapy Help with a Neonatal Brain Injury?
During hypothermia treatment, the baby’s core body temperature is cooled down to just a few degrees below normal for 72 hours. Then the body temperature is slowly brought up to normal. Research shows that hypothermia treatment slows down almost every injurious process that starts to occur in the brain after an oxygen-depriving insult, and babies with HIE who receive the treatment are much less likely to develop cerebral palsy. Thus, HIE may not result in permanent brain damage if physicians diagnose it right away and promptly initiate brain cooling treatment. The more serious the brain injury, the sooner the hypothermia treatment should be given.
How Does Hypothermia Therapy Work?
When body temperature is lowered, it means that metabolic rate (the rate at which the body uses energy) slows down. This allows cells to recover over a greater period of time and minimizes a kind of damage known as reperfusion injury – an injury that happens when blood rushes back too quickly to an area already injured by oxygen deprivation or compromised blood flow.
What Should Doctors Do in Addition to Hypothermia Therapy?
Treating any type of brain injury involves supportive care designed to ensure adequate blood flow to the baby’s brain and minimize brain swelling and fluid build-up. If the baby has a brain bleed or hemorrhage, it must be quickly diagnosed and treated. Seizures must also be promptly treated because they can worsen existing brain injury and cause further brain damage. Sometimes seizures are difficult to recognize in a baby. Any baby suspected of having HIE or an insult to the brain should receive either continuous EEG monitoring or frequent EEG testing.
Permanent brain damage after a brain insult can be minimized if the medical team acts quickly with supportive care, treats underlying problems such as brain bleeds, and promptly diagnoses HIE so the baby can receive hypothermia treatment.
Legal Help for Neonatal Brain Injury Treatment
Hypothermia therapy is a critical component of care for mitigating the damage caused by birth injuries. It is of paramount importance that physicians properly diagnose and treat children with brain injuries, as a delay in treatment could mean that the crucial window of time in which hypothermia treatment is effective has passed. If you are concerned that a loved one was given hypothermia treatment too late or required hypothermia treatment due to an avoidable medical error, please contact our birth trauma team for a case evaluation.
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About Hypothermia Therapy
- How Hypothermia Therapy Works
- Errors in Administering Hypothermia
- How do Doctors Decide When to Give Hypothermia Treatment? [Infographic]
- Chau V, Poskitt KJ, Miller SP. Advanced neuroimaging techniques for the term newborn with encephalopathy. Pediatr Neurol 2009; 40:181.
- Barnette AR, Horbar JD, Soll RF, et al. Neuroimaging in the evaluation of neonatal encephalopathy. Pediatrics 2014; 133:e1508.
- Roland EH, Poskitt K, Rodriguez E, et al. Perinatal hypoxic-ischemic thalamic injury: clinical features and neuroimaging. Ann Neurol 1998; 44:161.
- Bonifacio SL, Saporta A, Glass HC, et al. Therapeutic hypothermia for neonatal encephalopathy results in improved microstructure and metabolism in the deep gray nuclei. AJNR Am J Neuroradiol 2012; 33:2050.
- Barkovich AJ. MR and CT evaluation of profound neonatal and infantile asphyxia. AJNR Am J Neuroradiol 1992; 13:959.
- Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 1976; 33:696.