Cooling Therapy - HIE - Potential Benefits
Infants diagnosed with hypoxic ischemic encephalopathy, HIE, have few options for treatment. In fact, until about ten years ago there were no known ways to reduce brain injuries in these children and many of them did not survive.
Get A 100% Free CASE EvaluationTherapeutic hypothermia is currently the only known treatment for HIE that provides the potential for improvement in long-term outcomes.
Cooling Therapy for Better Outcomes
Newborns with HIE who were cooled immediately following birth had fewer deaths and exhibited better long-term outcomes than infants who did not receive cooling therapy. The Neonatal Research Network has completed a number of studies and has concluded that hypothermia is a safe and effective therapy for birth asphyxia. One study found that infants with moderate to severe HIE were more likely to survive to 18-22 months with less neuro-developmental impairment. Children were again examined once they reached school age. The findings indicated that the children who received hypothermia treatment were more likely to survive to age 6 or 7.
Potential for Improved Brain Function
Today more is known about how brain injuries occur in infants. Brain injuries due to asphyxia, or lack of oxygen, occur in two distinct phases. The first phase is the occurrence of the injury, the time the brain is deprived of oxygen. During this phase the cells begin to die. As they do they produce an enzyme substance that causes damage to cells later on. Once normal oxygen supply is restored to the brain it begins to function properly again. However, the enzymes that were produced still exist.
The second phase of injury occurs during a time period generally between 6 hours and 72 hours after the injury. During this time the enzymes that were produced cause damage or death to additional brain cells. It is believed that the damage caused during this phase can be diminished with the application of newborn cooling therapy. Thus, cooling may inhibit further brain damage from occurring. It may also encourage the body to repair damaged cells.
Therapeutic hypothermia may prevent or reduce the effects of brain damage in the secondary phase of injury. Thus, the child does not have a further injury. The degree of the injury may be lessened by bringing the child’s core temperature down during this time frame. Therapeutic hypothermia may also help the body heal the damage that already occurred. By slowing the metabolism the body is better able to concentrate on repairing cell damage.
Neonatal Cooling Therapy
The need for infant cooling is assessed on an individual basis. Infants who have experienced mild, moderate or severe brain asphyxia could potentially benefit from therapeutic hypothermia. The full benefits of cooling may not be fully known until the child begins to grow. There are few side effects to having therapy, so it is generally considered a safe treatment. Therefore, the potential for benefit typically supports the use of this type of treatment.
Although going through cooling treatment can be difficult for parents to watch, it may ultimately provide the best possible outcome for the child. Spending just three days in the Neonatal Intensive Care Unit, NICU, can reduce a child’s risk of death and can improve the chances of reduced neurological damage.