Hypothermia Therapy Reconsidered
We previously discussed Hypothermia Therapy. Essentially, the theory is that children who suffered lack of blood and oxygen during labor and delivery could be protected from injury, to a degree, by keeping the baby cold shortly after birth. Early studies going back to the 1980s showed that lower temperatures could reduce brain cell death. Doctors have been experimenting with two methods—the first is to cool the baby’s entire body; the second is to simply cool the baby’s head using a special cap (approved by the FDA in 2006).
A December 2014 article in The Journal of the American Medical Association (JAMA), Effect of Depth and Duration of Cooling on Deaths in the NICU Among Neonates With Hypoxic Ischemic Encephalopathy examined the use of longer hypothermia therapy to see if it would reduce death or disability. In the study, groups of babies were assigned to one of four groups at a cooling temperature of 33.5 degrees or 32 degrees, and for 72 hours or 120 hours. In general, the study revealed that neither variable—longer cooling or colder temperatures, had any effect on death. Importantly, the study did not investigate whether the outcomes of those babies who survived was superior to babies who were cooled at higher temperatures or for less time. The evaluation of the disability component is still pending.
The take home message is that cooling is still a good idea, and that it can decrease the likelihood of death after hypoxic ischemic encephalopathy (HIE—essentially complicated medical jargon for lack of oxygen or blood). That is a serious problem during labor and delivery, one which can cause cerebral palsy and mental impairment.
Cooling therapy continues to be used and useful, but ongoing research is dedicated toward refining the process. After an avoidable or unavoidable insult during labor and delivery, doctors may need to offer this treatment to prevent a more significant injury, or death, to the baby. For more information on whether your doctors followed the standard of care, contact our medical malpractice attorneys at (440) 252-4399 or online for a free consultation.