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Therapeutic hypothermia is a treatment that lowers a newborn's body temperature in order to prevent or minimize brain damage caused by lack of oxygen or another injury before or during birth.
Scientific research and clinical observation have shown that body temperature seems to have an affect on how a person heals from an injury. People who are colder when they are injured seem to be hurt less and heal faster from certain types of injuries than people who are warmer when they are injured. An example of this phenomenon is a child falling into an icy lake and making a full recovery after several minutes underwater.
Doctors still are not completely sure what makes therapeutic hypothermia work. It could be a slowing down of normal biological functions, a reduction of inflammation or some other unknown process. While researchers continue to study the procedure in order to better understand how it works, many experts continue to advocate for this treatment because it has been shown to significantly improve neurodevelopmental outcomes for newborns with:
- Neonatal encephalopathy. Neonatal encephalopathy—or birth depression—is a condition of disturbed neurological function in a newborn that can lead to respiratory problems and seizures.
- Hypoxic ischemic encephalopathy. Hypoxic ischemic encephalopathy is a type of neonatal encephalopathy that is caused by low oxygen during birth.
- Other brain injuries. Physical trauma during birth may cause a brain injury.
Therapeutic hypothermia also minimizes and sometimes prevents long-term complications associated with these conditions such as cerebral palsy, learning or intellectual disabilities and hearing and vision problems.
While approximately one in four babies with a condition requiring therapeutic hypothermia may still go on to experience neurodevelopmental issues, the treatment significantly improves outcomes and is currently the only known therapy to do so.
What to Expect
What to Expect
As a treatment for neonatal brain injury, therapeutic hypothermia is the most effective when started within six hours after birth. The treatment will continue for three days which is the standard length of time needed for the brain to start recovering.
In the neonatal intensive care unit (NICU) at Riley at IU Health, your baby will be placed in a special bassinet with a cooling blanket. A special probe inserted either into your baby’s throat or rectum will monitor your child to ensure that his or her body temperature remains in a safe range. The cooling blanket will constantly adjust its temperature based on readings from the probe.
While undergoing this treatment, your baby will also be monitored around the clock with an electroencephalogram (EEG) to watch the brain’s condition and activity levels. Seizures are common, so this monitoring allows for immediate treatment. A neurophysiologist and pediatric neurologist are on-site 24 hours a day to provide immediate treatment if seizures or other abnormal EEG activity occurs.
A pediatric neurologist will follow your baby’s care after he or she leaves the NICU. At the conclusion of therapeutic hypothermia treatment, all babies receive a magnetic resonance imaging (MRI) scan to evaluate the brain before they go home.
Key Points to Remember
Key Points to Remember
- Therapeutic hypothermia helps to reduce long- and short-term complications of brain trauma or low oxygen during birth by lowering a newborn's body temperature and reducing inflammation.
- While this treatment helps to improve neurodevelopmental outcomes, it may not be possible to prevent all complications.
- Your baby’s body temperature and brain activity will be constantly monitored during the treatment.
- Once treatment is complete, your baby will receive an MRI, and a pediatric neurologist will provide additional follow-up care.