How Effective Is Therapeutic Hypothermia for HIE? December 12, 2023.

How Effective Is Therapeutic Hypothermia for HIE?

New medical advancements are made every day, particularly in the field of neonatal post-birth injury intervention. In the case of Hypoxic-Ischemic Encephalopathy (HIE), innovative treatments like therapeutic hypothermia show promise for treating the after effects of oxygen deprivation during the labor and birthing process.

This is critical for families of children who have suffered a birth injury. Below, learn what therapeutic hypothermia is, how it works, and how you can get legal support if you're the parent of a child who was injured at birth.

What Is Therapeutic Hypothermia? 

Therapeutic hypothermia is the practice of cooling the body to slow down cell activity, usually after an injury or trauma. This helps reduce the risk of complications caused by the lack of blood flow to the brain and heart and is a common treatment for neonatal hypoxic-ischemic encephalopathy (HIE).

During the procedure, blood vessels become less constricted and the body has an easier time transporting oxygen to important places. It also plasma insulin levels, reduces intracranial pressure, stabilizes cardiac output, and more. Other applications for therapeutic hypothermia include heart attacks, sudden injuries, and strokes, according to medical journal Cardiology in Review.

How Does It Work?  

In cases where a child has been deprived of oxygen during the birthing process, therapeutic hypothermia will usually be started within the first six hours of life to reduce the risk of permanent brain injury and improve long-term neurological outcomes. Initiating this treatment early is key to successful intervention. The more time that passes after the initial injury, the more cell death and damage occurs and the higher the chances are for serious problems.

During the treatment, the child's body temperature will be lowered to around 92 to 94 degrees Fahrenheit, or about 4 to 6 degrees lower than normal. This is done either via surface cooling or endovascular cooling, according to a 2012 paper published in the Current Treatment Options in Neurologyjournal. Then, this temperature is maintained for a specific period of time within the target range.

This usually is around a few days at most. Once the cooling phase is complete, the child's body temperature is slowly increased to avoid shocking the body. Medical personnel may also provide other supportive care during this treatment depending on the case, like respiratory support and bilirubin monitoring.

Risks and Benefits of Hypothermia Treatment 

There are many clinical benefits of therapeutic hypothermia, including:

  1. Reduced risk of long-term complications. Therapeutic hypothermia has been shown to reduce the severity of disabilities caused by asphyxiation during the birthing process, including developmental delays and cerebral palsy.
  2. Lower mortality rates. Hypothermia treatment reduces the chances of newborn death after an asphyxiation incident during birth.
  3. Increased myocardial contractility. Hypothermia treatment is effective at increasing the forcefulness and capacity of the heart muscle, which ultimately improves the volume of blood that can be pumped per each beat.

Like with all medical procedures, there are also some inherent risks to be aware of, like:

  1. Potential for overcooling. It's crucial that medical staff carefully monitor newborns receiving cold therapy to prevent overcooling, which can cause even more problems like cardiac arrhythmias and bleeding disorders. 
  2. Complications with rewarming. Warming the body up too fast after hypothermia treatment can result in electrolyte imbalances and dangerous changes in blood pressure.
  3. Metabolic acidosis. Because hypothermia treatment changes the body's natural metabolic processes, this could potentially lead to acidosis if medical staff aren't diligently monitoring blood pH levels.

Most potential issues can be mitigated by carefully selecting newborns who are good candidates for the procedure. The criteria used to evaluate a newborn's condition and eligibility for therapeutic hypothermia include abnormal neurological symptoms, low Apgar scores, and/or evidence of birth asphyxia and oxygen deprivation.

Therapeutic hypothermia is a well-established intervention for newborns at risk of neurological injury due to HIE. In most cases, the benefits for infants who meet qualification criteria outweigh the potential risks. However, the treatment must be administered correctly and special care is required due to the small and delicate nature of newborns.

When to Contact a Qualified Cleveland Birth Injury Attorney

If you suspect that your child may have suffered from an injury during birth, you have many legal rights available that you can – and should – exercise. 

At the Mellino Law Firm, we’ll start by carefully reviewing your child's medical history to determine who may be at fault and will look at every possible avenue to help you obtain the justice and compensation your family deserves.

Contact us today to learn more about filing a birth injury lawsuit or to schedule your free initial consultation by calling (440) 333-3800.