Whole body hypothermia therapy for neonatal encephalopathy
About hypoxic ischemic encephalopathy
Hypoxic ischemic encephalopathy (HIE) is a type of brain damage that occurs when an infant's brain doesn't receive enough oxygen and blood. HIE is a result of inadequate placental or fetal perfusion and affects approximately two out of every 1,000 live births worldwide. About 10 to 60 percent of infants with HIE will die and, of the survivors, 25 percent will exhibit significant neuro-developmental issues such as epilepsy, deafness and motor and cognitive deficits. HIE is a dangerous condition that requires immediate medical intervention.
Hypothermia as treatment
In infants born at 36 weeks or more gestation, hypothermia initiated within six hours after birth and extending for 72 hours has been shown to significantly improve neonatal outcomes in many randomized clinical trials and has become the standard of care since 2008. Hypothermia can be accomplished by whole body cooling using a cooling blanket or by selective head cooling. To identify the extent of brain damage, MRI is done when the infant in clinically stable, usually five to 14 days after birth.
Cohen Children’s was a participant in the research study (Cool Cap®) investigating the impact of selective head cooling on outcomes for select infants with HIE. After completion of the study in 2002, selective head cooling became our standard of care.
Always on the forefront of innovation, we started moving toward whole body cooling in 2015. Our team has extensive knowledge of whole body cooling for infants with HIE, as well as experience in the use and interpretation of amplitude-integrated electroencephalography (aEEG) during hypothermia treatment to identify seizure activity and help predict outcome.
Our team includes pediatric neuroradiologists who analyze images from newly installed MRI machines with updated techniques to better visualize brain damage and assist in predicting outcome. In 2018, we officially switched to whole body cooling method for treatment of infants with HIE. You can rest assured we always provide your child with the most up-to-date treatment methods, and we continuously strive for improvement in our field.