Can Neonatal Cooling Improve Outcomes Following Birth Injuries?

a newborn baby

When a baby is born with hypoxic-ischemic encephalopathy (HIE), a lack of oxygen or blood flow to the brain, doctors have a short window of time to prevent further damage as a result of this birth injury. One way they can do this is by cooling the baby's body. This is called therapeutic hypothermia or neonatal cooling.

What is Neonatal Cooling?

Cooling the baby's body temperature can help reduce damage to the brain that can occur during and after birth. Brain damage can lead to serious problems such as:

  • Cerebral palsy (CP)
  • Seizure disorders
  • Cognitive problems
  • Problems with motor control
  • Speech disorders
  • Behavioral disorders
  • Visual or hearing deficits

Neonatal cooling is not a new treatment, but it has become the standard treatment for HIE in recent years as more research has shown its effectiveness at reducing the damage caused by hypoxic ischemic birth injuries.

How Does Neonatal Cooling Work?

Neonatal cooling works by lowering the baby's body temperature to between 32°C and 34°C for a period of 72 hours. This can be done using a cooling blanket or mattress or by circulating cool water through a special suit that the baby wears. The baby's head is also kept cool with special pads.

The cooled baby is closely monitored for signs of hypothermia, such as low heart rate and blood pressure, unstable blood sugar levels, and difficulty breathing. Treatment is stopped if the baby shows any signs of hypothermia.

What Are the Benefits?

Studies have shown that cooling the baby's body immediately after birth can help reduce the risk of brain damage and improve long-term outcomes.

One study examined the effects of neonatal cooling performed within 6 hours of birth on infants with mild HIE. The results showed that 27 percent of infants in the control group (non-cooled) experienced seizures while none of the infants who received neonatal cooling experienced any. Additionally no adverse neurodevelopmental outcomes at 2 years were present in cooled babies compared to 14.3 percent of non-cooled babies.

In a 2005 clinical trial, 102 neonates were placed into a group that received whole-body hypothermia while 106 were assigned to a control group. The trial concluded that whole-body hypothermia decreased the rate of mortality and disability in neonates with HIE (44 percent compared to 62 percent). It also reported that within the hypothermia group of infants, the rate of CP was 19 percent while the control group had a 30 percent rate of CP.

Seven years later, the team was able to record an updated analysis of their 2005 trial, and monitor long-term outcomes from the test group. The now 6 to 7 years old children who received cooling treatment still maintained a lower mortality rate and reduced risk of death or being left with moderate to severe disabilities compared to children who were not cooled as babies.

Are There Any Risks?

Neonatal cooling is generally considered safe, but there are some risks associated with the treatment. These include:

  • Respiratory Complications: Oxygenation difficulties may occur with induced constriction of pulmonary arteries and high blood pressure affecting the arteries in the lungs.
  • Bradycardia: This is an abnormally slow heart rate that can occur when the body temperature is lowered.
  • Electrolyte Imbalance: Due to low levels of potassium, sodium, magnesium and phosphorus.
  • Temperature Instability: There is also a risk that the baby's body temperature will become too low (hypothermia) or too high (fever) during treatment.
  • Cerebral Edema: In some cases, without sufficient fluids, cooling can cause an increase in swelling around the brain (cerebral edema). This usually happens when cooling is stopped too quickly. Cerebral edema can lead to neurological problems such as seizures or paralysis.

Birth Injury Attorneys at Daniel, Holoman & Associates LLP

If your baby suffered a birth injury due to medical negligence, contact our experienced birth injury attorneys at Daniel, Holoman & Associates LLP. We can help you seek financial compensation for your child's medical care and other damages.

If you think you or your newborn has experienced a birth injury, call us today at (866) 380-2281 for a free consultation.

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