More than a few studies have been conclusive showing that infants with hypoxic-ischemic encephalopathy have benefited when cooled to a temperature of 30 degrees Centigrade in a median time of 58 minutes. The cooling of newborns inspired oxygen requirements in a test involving six infants diagnosed with HIE.
Five of those infants required inotropic support during the cooling procedure. The cooling would be progressively reduced after 1-2 days. Inotropic support is the intensive care of newborns to stabilize circulation and to optimize oxygen supply.
Over the years, HIE has been recognized much more frequently. The onset of cases of HIE are caused by stroke, compressive forces or changes in oxygen circulating through the fetus before and immediately after delivery.
The use of therapeutic cooling began in 2010 for moderate-to-severe HIE cases. However, medical trials continue investigating the benefits of TH in infants that do not fit the criteria. That means that infants with mild encephalopathy could be treated with cooling more than six hours after the delivery of the child.
Because the standard use of cooling infants began as recently as 2010, there is not much evidence or even medical literature that shows the benefits or the lack of benefits of children who are treated that way and who were diagnosed with moderate-to-severe HIE.
In cases where negligence is alleged, the lack of supporting medical literature showing the benefits of cooling makes the proof of future damages for a brain injured child more difficult.
At this time, TH is utilized for newborns diagnosed with moderate-to-severe HIE in the first six hours after delivery. HIE may be a progressive and devastating injury to the brain. To reduce the severity of HIE, it has been shown that cooling has either slowed or stopped the HIE progression.
The evidence of this is shown in MRIs. At least one study evaluating the effects of cooling of a 24-month infant showed that the post-cooling imaging revealed only minor focal white matter injury that could be related to cognitive deficits at age two years. This would be the case in about 2/3 of the newborns in that study.
One of the requirements of the use of TH is that the infant not be premature. Another prerequisite is that the infant would have no congenital malformations.
Importantly, in one study it has been shown that TH does not significantly affect developmental delay or intellectual impairment later in the child’s development.
Additional updates on this subject are regularly being examined by labor and delivery professionals.
Kreisman Law Offices has been handling birth trauma injury lawsuits, brain injury cases, labor and delivery negligence lawsuits and medical malpractice cases for individuals, families and loved ones who have been injured, harmed or killed by the carelessness or negligence of a medical provider for more than 40 years, in and around Chicago, Cook County and its surrounding areas, including Alsip, Blue Island, Calumet Park, Burbank, Bedford Park, Schiller Park, River Grove, Chicago (Garfield Ridge, Midway, Archer Heights, Little Village, West Town, Greek Town, Ukrainian Village, Goose Island, Near North, Old Town, Gold Coast, Logan Square, Roscoe Village), Norridge, Wood Dale, Villa Park, Rolling Meadows and Highwood, Ill.
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