Cooling Therapy – Blood Clots
It is the nurse’s position at the bedside that offers the first line of intervention when there are complications in an infant with HIE who is undergoing cooling therapy. A nurse must have an intimate understanding of what he or she should anticipate as well as the fleeting changes in baseline monitoring parameters.
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Coagulation, or the process of clotting, is prolonged during hypothermia. However, if the coagulation seems to be normal prior to therapy, the baby is less likely to experience problems as a result of the treatment.
t must be noted, though, that it is not unusual for the asphyxiated baby to experience abnormal clotting as a result of injury to the liver. This is why it is important for medical professionals to monitor liver function tests at regular intervals during the cooling treatment. Nurses will also be on the lookout for physical signs which include:
- Petechiae
- Venipuncture sites that are oozing
- Gastric secretions
- Bloody urine
- Endotracheal secretions
Usually, side effects are resolved or return to baseline when the core body temperature warms up. Most side effects do not usually interfere with the management of administering cooling therapy.
Blood Clotting Disorders in Infants
Clotting usually occurs as a result of chemical changes in the blood. The clots work to repair damaged vessels and cease the bleeding. However, clots can also form when there is no bleeding or injury, such as during therapy. They may block arteries or veins, interrupt blood flow to part of the infant’s body, and prevent flow to organs like the heart, brain, and lungs.
Diagnosing Blood Clotting Disorders
Diagnosis of a clotting disorder is often based on current symptoms, medical and family history. Blood tests include:
- Clotting tests to determine the level of disorders in the infant’s blood and how long a clot takes to form
- Completed count – this test checks both red and white cells and the platelets.
- Genetic tests check for gene defects known to result in clotting disorders.
Treating Blood Clots
A hematologist is a specialist in blood disorders. Medicine is usually the main treatment for clotting and can be administered during the hypothermia method. Medication may include:
- Aspirin
- Anticoagulants, or thinners, that are given intravenously into the infant’s vein
Cooling therapy has proven beneficial in reducing the risk of neurological impairments like cerebral palsy as well as the risk of death in babies who suffer HIE and stroke.
The treatment works to halt just about every cellular process involved in the injury that occurs after HIE/stroke. When the treatment is administered, the brain injury tends to be less severe. However, as mentioned earlier, clotting may occur and must be watched out for in order for appropriate treatment to be given.