Therapeutic Hypothermia

Therapeutic hypothermia, also known as targeted temperature management or neonatal cooling, is a medical treatment used in neonatal intensive care units (NICUs) to reduce the risk of brain injury in newborns who have experienced a lack of oxygen (hypoxia) during birth. At Kanumuri Hospital in Guntur, therapeutic hypothermia is likely employed as part of their advanced neonatal care practices to support newborns with hypoxic-ischemic encephalopathy (HIE) or other conditions resulting from perinatal asphyxia.

What is Therapeutic Hypothermia?

Therapeutic hypothermia involves cooling the newborn's body to a temperature slightly below normal for a specific period, usually 72 hours. This controlled cooling slows down the metabolic rate, which can help reduce the extent of brain injury and improve neurological outcomes. The process typically involves reducing the baby's core body temperature to around 33.5°C (92.3°F).

Indications for Therapeutic Hypothermia

Therapeutic hypothermia is indicated for newborns who:

• Have suffered from perinatal asphyxia, leading to reduced oxygen supply to the brain.
• Show signs of moderate to severe hypoxic-ischemic encephalopathy.
• Are full-term or near-term (typically 35 weeks gestation or more).

How Therapeutic Hypothermia is Administered

At Kanumuri Hospital, the administration of therapeutic hypothermia may involve the following steps:

• Assessment and Diagnosis: Newborns are assessed for signs of HIE and eligibility for therapeutic hypothermia. This may include clinical evaluations, blood tests, and neuroimaging.
• Cooling Initiation: Cooling is typically initiated within six hours of birth. This can be done using specialized cooling blankets, caps, or mattresses designed to regulate the baby's temperature precisely.
• Monitoring: Throughout the cooling period, the baby’s vital signs, including heart rate, respiratory rate, blood pressure, and oxygen levels, are closely monitored. Continuous EEG (electroencephalogram) monitoring may be used to assess brain activity.
• Maintaining Target Temperature: The baby’s core body temperature is maintained at the target level (around 33.5°C) for 72 hours. The cooling equipment automatically adjusts to maintain this temperature.
• Rewarming: After 72 hours, the baby is gradually rewarmed to normal body temperature over a period of several hours. This gradual process helps prevent complications associated with rapid temperature changes.
• Follow-up Care: After rewarming, the baby continues to receive intensive monitoring and supportive care. Follow-up evaluations, including neurological assessments, are conducted to monitor the baby’s recovery and development.

Benefits

• Neuroprotection: Therapeutic hypothermia can reduce the risk of severe brain injury and improve long-term neurological outcomes.
• Reduction in Mortality: It can lower the risk of death in newborns with HIE.