The infant’s condition may require medications during treatment. Cooling treatment is provided in a Neonatal Intensive Care Unit, NICU, which offers this type of care.

Sedation

Infants are usually sedated while they receive neonatal cooling therapy. This is done to help keep the infant calm during treatment and to assist in care. It may also help control seizures. While under sedation the child must be provided nutrition intravenously. The child’s vital signs are constantly monitored, and the baby’s brain activity might also be tested throughout this time period. There could be many diagnostic connections, tubes, and other things that are attached to your infant during cooling as these are a necessary part of patient monitoring and administration of medication.

Seizure Control

Infants that suffer from hypoxic ischemic encephalopathy, HIE, may suffer from seizures. When the lack of oxygen occurred before labor began, seizures most often occur within the baby’s first 12 hours after birth. When oxygen deprivation happened during labor or delivery seizures might not occur until about 18 to 20 hours after birth. Infants are monitored using electroencephalogram, EEG. This may provide some detection of seizures.

Seizures are usually controlled with medication. The use of an EEG will help doctors determine how well a particular medication is working to suppress them. The presence of seizures is not indicative of a negative long-term prognosis. In many infants, seizures will subside in the first few days of life.

The doctor may prescribe an anticonvulsant or anti-excitatory drug to reduce or calm seizures. Medications that may be used to control seizures include Phenobarbital, levetiracetam, phenytoin, lidocaine, and benzodiazepines or others. The newborn should remain calm and sedated so that the treatment can be effective and the child will be as comfortable as possible.

Other Medications

An infant receiving therapeutic hypothermia may also require some other medications. For instance, medication may be needed to properly control blood pressure. Anti-inflammatory or anti-oxidants by be provided. The infant’s vital signs are closely monitored while the infant is in the NICU. Other medications may be required. If necessary, they will typically be provided intravenously.

While side effects from therapeutic hypothermia are usually minor, if they occur they can be treated with medications. Some side effects that have been reported include mild bradycardia, mild hypertension, arrhythmias, mild thrombocytopenia and sclerema/edema. Not all infants suffer side effects from cooling treatment.

The infant’s condition is always being evaluated so that proper medications will be given if needed. If a medication is no longer necessary, it will no longer be given. The medical team will provide the correct dosage based on the infant’s specific needs.

Nutritional Support

When an infant is receiving cooling therapy in NICU, he must get proper hydration and nutrition. Electrolytes can be utilized to establish hydration and maintain normal glycolic levels. During the initial treatment fluid intake may be restricted to reduce any incidence of cerebral edema. Once cooling treatment is complete, the newborn’s temperature is slowly brought back up to normal. The baby will be evaluated to determine which, if any, medications should be continued.