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Hypothermia Reduces Neonatal Hypoxic-Ischemic Brain Damage

Photo of Armand Leone

Whole body cooling reduces brain damage from oxygen deprivation during birth and can lessen death and disability rates for these infants. A study of the use of hypothermia therapy (reduced body temperature) for babies with a gestational age of 36 weeks or more and who had severe asphyxia during birth was performed. Infants were randomly assigned to normothermia or hypothermia, and neurodevelopmental outcomes were assessed at 18 to 22 months of age. Without hypothermia, infants with severe encephalopathy have a 60% chance of death and those that survive are handicapped. Reductions in brain temperature provide neuroprotection when assessed in animal experiments. The use of whole body cooling initiated within 6 hours of a birth and continued for 72 hours was studied. The results showed a decrease in death from 62% to 44% with hypothermia. The incidence of disabling cerebral palsy decreased from 30% to 19%.

Hypothermia can be accomplished by whole body cooling or selective cooling of the brain. Whole body cooling has the ability to achieve consistent reduction in temperature, including the deep brain structures that are critical to normal neurological functioning. This reduces brain damage that would otherwise occ ur. One concern was that hypothermia may decrease the death rate but increase the number of babies surviving with severe disability. However, this study showed no increase in disability but rather a decrease in deaths and also a decrease in the disability in those who survived.

Britcher Leone & Roth understand the importance of prenatal and perinatal care for mothers and newborn babies. When care is not properly given, the result is medical malpractice. Babies can suffer from lack of oxygen and infection that can cause irreversible brain injury. While not all instances of neurological injury in newborns is preventable, only a close examination of the prenatal and perinatal care can determine if neurological injury was the result of negligent care. Regardless of the cause of hypoxic injury during birth, prompt recognition of the need for and use of hypothermia can lessen the impact of otherwise devastating injuries.

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