Neonatal Therapeutic Hypothermia

Neonatal Therapeutic Hypothermia (Cooling)

Treatment for Hypoxic-Ischemic Encephalopathy (HIE)

What is Hypoxic-Ischemic Encephalopathy (HIE)
Hypoxic-ischemic encephalopathy (HIE) is a type of birth injury caused by oxygen deprivation and/or limited blood flow to the brain at or near the time of birth. It can result in permanent brain damage, lifelong disabilities such as cerebral palsy (CP), and even infant death. A treatment called therapeutic hypothermia (also referred to as “cooling”) might reduce the severity of the brain injury/birth injury if your baby suffered a brain injury due to a lack of oxygen during labor and delivery.

What is Neonatal Therapeutic Hypothermia? Therapeutic hypothermia (also known as hypothermia therapy, brain cooling, cooling therapy, and cooling treatment) is a procedure used to help slow down the brain injury process associated with HIE.

Therapeutic hypothermia is now a standard treatment for HIE if your baby suffers a birth injury and meets certain criteria.. It can slow down the injury process, allowing the baby’s brain to heal and minimizing the spread of damage.

Lowering the body’s temperature slows the metabolic rate and allows cells more time to recover from neurological damage resulting in brain injury to the baby. Cooling therapy for birth asphyxia has been shown to positively affect the following in infants with HIE:

• Nitric oxide production
• Apoptosis
• Cerebral metabolism and blood flow
• Excitatory amino acids
• Cerebral energy

Guidelines for Cooling
Guidelines for cooling vary from Hospital to Hospital. Therapeutic hypothermia should be given when a baby suffers a birth injury/brain injury and the following criteria are met:

• The baby is less than six hours of age and was born after at least 36 weeks of pregnancy
• At least one of the following:
  - A complication before delivery, such as cord prolapse, uterine rupture, or profound fetal bradycardia
  - An APGAR*score of five or lower at 10 minutes of life
  - Prolonged resuscitation at birth
  - Severe acidosis
  - Abnormal base excess within 60 minutes of birth, as shown in umbilical cord gas or neonate blood gas
• At least one of the following:
  - Signs of neonatal seizures - Evidence of neonatal encephalopathy in a clinical exam

*APGAR: (Appearance, Pulse, Grimace, Activity, Respiration) Score ranges:
Critically Low 0-3
Below Normal 4-6
Normal 7+

When should a baby not receive therapeutic hypothermia?
Guidelines state that babies should not receive therapeutic hypothermia if they had a premature birth (under 34 weeks into pregnancy), and that physicians should exercise extreme caution if they weigh less than 3-4 lbs., have severe congenital abnormalities, suffered major intracranial hemorrhage (brain bleed), have overwhelming septicemia (blood infection), or show evidence for a blood clotting disorder that could make the treatment dangerous.

Cooling is now a “standard of care” for certain babies that suffer a birth injury or brain injury from a lack of oxygen during labor and delivery. If your baby needs to receive cooling to slow or reverse some of the brain injuries, your doctors, nurses and the hospital can be held liable for failing to provide cooling treatment for your baby. If the doctors, nurses and hospital did not follow procedure and meet standards of care, that constitutes medical negligence and medical malpractice. Medical providers should inform parents whether their baby’s medical condition due to a birth injury requires them to receive cooling therapy.

As experienced Birth Injury Lawyers, we fight hard for answers and justice if a delivery room error or doctor's negligence caused your child's birth injury.

If your child suffered a serious injury or lifetime disability due to a mistake before, during or after delivery, a lawsuit may be the best way to find out once and for all what happened and who should be held responsible. Contact us today to schedule a free consultation with an experienced birth injury lawyer. We encourage you to call our offices today at 214.987.0005 or toll free at 888.987.0005.