Medical Negligence
Cooling therapy for newborns with Hypoxic Ischaemic Encephalopathy (HIE)
3 minute read
Hypoxic Ischaemic Encephalopathy (HIE) occurs when a baby’s brain does not receive enough oxygen and/or blood flow around the time of birth. Low oxygen and/or blood flow to the baby’s brain occurs most often before or during birth, but it can also happen shortly after birth.
Hypoxic Ischaemic Encephalopathy affects the central nervous system
HIE affects the central nervous system and babies born with HIE may have neurological or developmental problems. It is not always possible to know what causes HIE however, it is often caused by complications during labour and delivery such as issues with blood flow to the placenta, heart disease, very low or high blood pressure in the mother, placental abruption, uterine rupture, prolonged labour, cord entanglement or compression.
If a baby has moderate to severe HIE, there is a risk of long-lasting damage to the brain or death
In many cases, HIE is often suspected shortly after birth and diagnosed in the first few days after birth. If a baby has moderate to severe HIE, there is a risk of long-lasting damage to the brain or death. In severe cases, a baby may have delays in growth or development. They may also have cerebral palsy or other disabilities and the severity of these symptoms may not be seen for a few years.
Cooling therapy as a HIE treatment
Therapeutic Hypothermia or Cooling Therapy is regarded as one of the greatest single advances in Neonatology over the last 25 years as research has demonstrated it reduces the rate of death, severe disability and lifelong cerebral palsy reduction for these infants.
What is therapeutic hypothermia / cooling therapy?
To reduce the risk of long-lasting damage to the brain, babies with moderate or severe HIE are likely to receive a treatment called Therapeutic Hypothermia or cooling therapy. Cooling Therapy should be given within the first six hours after birth. The therapy involves using a special cooling mattress to lower the baby’s temperature to between 33°C and 34°C for 72 hours.
Cooling helps to slow damage to brain cells and prevent further toxins from forming, limiting injury to the brain. During cooling therapy, the baby’s temperature will be monitored closely to ensure that it stays at the right level and cooling will usually be continued for 72 hours before re-warming.
The baby will be re-warmed over a period of 12 hours.
Therapeutic Hypothermia is administered in four tertiary maternity hospitals
In Ireland, Therapeutic Hypothermia is administered in four tertiary maternity hospitals: National Maternity Hospital, Rotunda Hospital, Coombe Women and Infants University Hospital and Cork University Maternity Hospital). All infants born in other hospitals requiring this treatment are transferred to one of these four tertiary hospitals.
By Mary Ní Ghuairim
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