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Therapeutic Hypothermia – which is a cooling treatment, is a relatively new option for treating newborn babies who have suffering from asphyxiation, or insufficient oxygen during labour and delivery. It involves reducing the infant’s body temperature by 2-3 degrees Celsius, resulting in modest hypothermia. The treatment works by reducing the brain’s use of energy, which slows disease progression and reduces the chances of the baby suffering from severe brain damage.
To meet the criteria for this treatment, the baby must be at least 36 weeks’ gestation. The baby must be less than 6 hours old to start cooling treatment. After 6 hours of age, cooling does not provide the same level of protection. Babies may not be eligible for the treatment if they have certain congenital abnormalities or if they have a very low birth weight. Cooling is only used in very specific situations – the baby must have severe acidosis demonstrated by a low umbilical cord pH, abnormal blood gases or base deficit, and a complicated delivery and low apgar scores, or have needed at least 10 minutes of help breathing. In other words, it must be shown that the baby’s condition is due to lack of oxygen around the time of birth. The baby must also show evidence of moderate to severe encephalopathy, demonstrated by a combination of signs and symptoms such as seizures, lethargy or coma, decreased or no activity, abnormal posture, decreased muscle tone, weak or absent reflexes and abnormal heart rate, pupils or breathing.
There are two main methods of cooling the infant – whole body cooling and selective head cooling. The type of cooling used depends on the hospital, but both methods have been shown to be safe and effective in bringing core body temperature down to therapeutic levels. Rewarming begins after 72 hours of cooling, and serial monitoring of the infant’s core temperature is important to prevent overheating.
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Understanding Treatment for Cerebral Palsy
- Medical Interventions