What is Hypothermia Therapy?
Hypothermia therapy in newborns who experience birth asphyxia, the deprivation of blood and oxygen close to birth, is an important way to minimize future brain injury and even to prevent death. It involves keeping a baby cool for a period of time after birth.
The Science Behind Hypothermia Therapy for Neonatal Encephalopathy
In the 1980s medical researchers began investigating the benefits of hypothermia therapy on newborns who experienced asphyxia before birth. Their studies proved that cooling therapy had beneficial, life-saving and injury-preventing effects on babies. We now know that this is for three reasons:
Delayed Cell Death
Birth asphyxia causes the death of brain cells because those cells require blood and oxygen to survive. When a baby in utero undergoes a long enough period of time without blood or oxygen (often called an insult), brain cells will begin to die. Death of brain cells can cause developmental delays, cerebral palsy, or even death. Those cells do not die immediately, however. Infants who have MRI scans of their brains immediately upon birth, after experiencing birth asphyxia, often have very normal-looking scans. However, as the brain cells die over the course of the next few days, repeated MRI scans look worse and worse. Hypothermia therapy helps to minimize the number of brain cells that die because of birth asphyxia.
Excitotoxicity is the process by which nerve cells are damaged or killed by some neurotransmitters. Basically, neurotransmitters like glutamate can leak out from damaged brain cells. Those neurotransmitters have a harmful effect on other brain cells, and contribute to the death of those cells. Hypothermia therapy helps to reduce the spillage of those harmful neurotransmitters, thereby saving brain cells.
Apoptosis is an organized sequence of cell death, often called programmed cell death. Sometimes it is initiated by the body on purpose, but it can also be caused by injury to the cells. This helps to explain why some brain cells die so much later than others after experiencing an asphyxia injury.
Hypothermia Therapy Techniques
There are two types of hypothermia techniques:
Whole Body Cooling
The baby is placed on a waterproof blanket. Under that blanket (or through the blanket, depending on the device used), cold water is continually circulated and the baby’s body temperature is kept down.
In 2006 the FDA approved the use of a head cooling cap called the Olympic Cool-Cap. Some believe that head cooling is more effective than full-body cooling, and that it reduces negative side-effects associated with whole body cooling.
Failure to Use Hypothermia Therapy
Studies indicate that babies with moderate or severe birth asphyxia have better outcomes when they are treated with some type of cooling therapy. The baby’s body (whole body cooling) or head (head cooling) must be kept to a temperature of 33-34 degrees Celsius (91-93 degrees Fahrenheit) for about three days. According to most studies, cooling therapy should begin within six hours of the birth.
In one recent study, Childhood Outcomes after Hypothermia for Neonatal Encephalopathy, 208 children were studied—half received hypothermia therapy, and the other half received standard medical treatment. The children who received hypothermia therapy were more likely to survive, and less likely to have significant neurological disabilities at the 18 to 22 month age range. Those babies were evaluated at ages six and seven, and the babies who had the treatment had a better survival rate and less severe injuries, overall.
The technique can be relatively inexpensive, and can cost as little as $6,000.00. Hypothermia therapy, whether through head cooling or whole body cooling, is an important part of the standard of care for treating babies who have experienced birth asphyxia. Those hospitals which have the ability to do so must provide this treatment; those hospitals which do not have the equipment must quickly transfer the baby to another hospital that does.
If your baby was treated with whole body cooling or a Cool-Cap immediately after birth, he or she must have experienced birth asphyxia. It is possible that birth asphyxia was caused by medical malpractice. Likewise, if your child suffered loss of oxygen or blood during labor and delivery and was not timely treated with hypothermia therapy, you may be eligible for medical negligence lawsuit. Contact our attorneys at (855) 712-7818 or online for a free evaluation.
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