Whole Body Cooling For Infants

It may seem strange to think about cooling a baby after birth — after all, it is well known that a newborn is supposed to be kept warm after birth to help regulate its body temperature. However, in a small percentage of pregnancies, complications can occur before or during birth which cause a baby to become oxygen-deprived or have a lack of blood flow. This can destroy brain cells and cause severe neurological damage that can lead to intellectual disability, cerebral palsy and epilepsy. About 1-2 out of every 1000 babies born need to undergo whole body cooling.

In order for an oxygen-deprived baby to have the best outcome, within the first six hours after birth, we administer a treatment called therapeutic hypothermia, or whole body cooling, which involves lowering a newborn’s normal body temperature of 98.6°F to about 92.3°F — and keeping this temperature stable for 72 hours. During this time, babies stay in the neonatal intensive care unit at Texas Children’s Newborn Center where they are closely monitored.

Studies show that oxygen-deprived babies who were cooled shortly after birth have a better chance of reduced effects of brain injury. Cooling decreases the metabolism of brain cells so they don’t need oxygen as much and they “go to sleep,” allowing brain cells that would have otherwise died or been severely damaged to heal.

Whole body cooling for infants processAfter the 72-hour cooling period, the baby is slowly re-warmed to a normal body temperature over a period of 4-6 hours and those brain cells come back to life. Over the next day or two, an MRI of the baby’s brain is taken to determine how the baby’s brain is developing and doctors can talk to families about what to expect as their baby grows. While this treatment has been known to help, brain injury is still a possibility.

Once home, parents will regularly receive questionnaires asking specific questions about their baby’s development. Their feedback gives our medical team insight into their baby’s health and brain development and helps our team provide guidance on developmental therapies that might benefit their baby.

About Dr. Jeffrey Kaiser, Neonatalogist

I am a neonatologist at Texas Children’s Hospital. I'm an internationally recognized leader in neonatal neurology and a National Institutes of Health-funded researcher and was the first physician in the world to use U.S. Food and Drug Administration-approved head-cooling equipment on an infant who was oxygen-deprived at birth.

A principal and co-principal investigator on numerous research projects, my research focuses largely on preventing brain injuries in premature infants.

Posted in Intensive Care, Neonatology

5 Responses to Whole Body Cooling For Infants

  1. fiona says:

    interested in finding out how other systems function while body is below normal temperature, such as glucose, respiratory management under this “cold Stress” time.

    • Dr. Jeffrey Kaiser, Neonatalogist Dr. Jeffrey Kaiser, Neonatalogist says:

      Fiona,
      Thanks for your question. Everything including cellular metabolism “slows” down during hypothermia. The question about glucose is a great one because we do not know the answer. We know that infants with hypo- or hyperglycemia do not do as well as infants are normoglycemic. Does hyperglycemia represent dying and/or dead brain, since the brain uses most of the glucose? Why are some infants hypoglycemic? This is not known and we are studying this. Regarding the lungs, sometimes with hypothermia, there is increased oxygen consumption and increased pulmonary artery vasoconstriction. Thus, some cooled babies need more oxygen because of this. The lungs, however, do work well at the modest hyperthermia temperature of 33.5 degrees Celsius. Don’t forget that the arterial blood gases need to be temperature corrected!

  2. CC says:

    Awesome video. So nicely represent it. I really enjoyed it a lot. Thanks a lot for sharing this great post with us. I am so glad that I visit this post. So informative and useful information you have shared here. Ir’s been really great to be here. Eagerly waiting for more articles.

  3. Tim Innes says:

    Hello Dr. Kaiser –

    What is your position on monitoring the HIE patients for seizures? Recent studies at CHOP, UCSF and Stanford show a high degree of seizure and non-clinical seizure thorugh out the hypothermia therapy procedure.

    Tim

    • Dr. Jeffrey Kaiser, Neonatalogist Dr. Jeffrey Kaiser, Neonatalogist says:

      Thank you Tim for your question,
      My position is to perform continuous EEG as soon as an infant with HIE is admitted to the NICU, throughout the whole cooling and rewarming processes. That is currently our (Neonatology and Pediatric Neurology) standard of care at Texas Children’s Hospital.

      Regards,
      Jeff Kaiser

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