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Did Your Newborn Suffer Cerebral
Palsy or Another Brain Injury Before
or During Labor and Delivery?

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Our Birth Brain Injury Resource Guide

the guide

Get a FREE guide of resources available throughout Ohio to children and families of children who were born with brain injuries.

Our guide can help you build a foundation of knowledge and tools that will help you help your child
now and in the future.

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Therapeutic Hypothermia Monitoring and Support during Treatment

Babies born with hypoxic ischemic encephalopathy, HIE, have suffered from oxygen deprivation at some point during labor, birth, or shortly thereafter. Cooling therapy is used to improve the infant’s potential outcome. Therapeutic hypothermia treatment is provided in the Neonatal Intensive Care Unit, NICU.

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Monitoring During Cooling Treatment

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Because the infant is sedated, and the temperature is cooled, the baby must be monitored at all times during treatment. Infants with HIE may be at a high risk of death so heart rate monitors are often used. Some infants may require ventilation for several days after birth. Mechanical ventilation helps maintain proper blood gas and acid-base status to help in the prevention of hypoxia (low levels of oxygen), hyperoxia (high levels of oxygen) and hypocapnia. In particular, hypocapnia, lower than normal levels of carbon dioxide in the blood, can be very harmful to the outcome of babies with HIE and may worsen long-term outcomes.

The respiratory system of the infant must be continually monitored while undergoing cooling therapy. Additionally, babies with HIE are at risk for pulmonary hypertension. This condition may be treated with medication. It is important to note that cooling treatment could alter the way medications impact the system so caution should be taken to provide the proper dosages to HIE infants. After cooling treatment is complete, dosages of medications must be re-evaluated.

Seizure Management

Infants with HIE are at an elevated risk of seizures. Neonatal seizures may occur at any time but are more likely to happen early. In some babies seizures might subside in a few hours to a few days. Those with HIE can be more resistant to treatment than other babies. Anticonvulsant drugs may be essential for HIE infants, especially during the first several days of life. Newborns must be monitored for seizures throughout their stay in NICU.

Fluids and Electrolyte Support

Infants with HIE could have more difficulty sustaining proper fluid and electrolyte balance. While in the NICU the infant’s blood gases will continue to be checked to make sure that an imbalance does not occur. Keeping the infant properly hydrated and controlling adequate levels in the blood and oxygen is done through monitoring. Immediate adjustments must be made if any abnormalities are noted. In addition, urine output is closely checked and measured. In some cases, catheterization could be necessary. Every change to any part of treatment could have an impact on the infant’s unstable system.

Tests and Treatments

Various tests and treatments may be necessary as part of intensive care. An MRI provides brain imaging to assess brain damage caused by HIE. An EEG test may be done to measure the electrical activity in the brain. In some instances, the infant may undergo EEG monitoring the entire time in NICU. This allows the doctors to see whether there are any changes to brain activity. Catheters are used to measure blood pressure and are used directly in the vein or artery of the umbilical cord. Some children may require intubation, a breathing tube placed in the windpipe for assisted breathing.


The Neonatal Intensive Care Unit specializes in providing high-quality care to infants who are critically injured or ill. The care that is provided is typically round-the-clock monitoring with highly skilled and experienced nurses. Parents may be allowed to visit the infant while in NICU, however, the baby likely can’t be held because it will cause a temperature change that is not tolerated during cooling treatment.