Babies on Ice

Hypothermia treatment for newborns with low oxygen has good long term outcomes

(RxWiki News) Sometimes that which does not kill you truly does make you stronger. Icing up a newborn may sound bizarre, but it could very well save a baby's life.

A recent follow-up study found that treating newborns who aren't getting enough oxygen with a special cooling treatment leads to a higher survival rate.

Additionally, this treatment produced no greater disabilities than the routine care these babies would otherwise have received.

"Doctors should treat oxygen-deprived newborns with cold water."

Seetha Shankaran, MD, of Wayne State University in Detroit, joined 26 other researchers in conducting this study to establish evidence on the long-term outcomes of babies treated with hypothermia for having low oxygen at birth.

Sometimes babies born on time do not get enough oxygen because of various birth complications, including blood loss. This condition, called birth asphyxia, can cause death in as many as half of all children that experience it.

It can lead to long-term brain damage and conditions like cerebral palsy, blindness or deafness. These children may also experience learning disabilities, delays in learning language or memory problems later in life.

One way to treat birth asphyxia, since 2005, is to reduce the body temperature of the newborn by circulating cool water beneath a waterproof blanket. After bringing the baby's temperature down to 91.4 degrees and keeping it there for 72 hours, the doctors then remove the blanket and let the baby's normal temperature return.

Shankaran's team has been following 208 children who were diagnosed with this condition, asphyxia, within their first six hours after being born. Some were treated with the cool water temperature reduction, and the others received routine care.

The researchers already published findings showing that the children who received the hypothermia treatment were more likely to be alive and less likely to have moderate or severe disabilities at 18 to 22 months old, such as blindness, deafness or cognitive problems, than the children who did not receive it.

For this follow-up study, the researchers analyzed data from 190 of the children to assess their health at ages 6 and 7. Of these children, 97 had received the hypothermia treatment, and 93 received routine care.

The researchers founded that 28 percent of the children in the hypothermia group had died, compared to 44 percent of the children who received routine care.

Of the 122 children who were still alive, the level of severe disability was similar between the two groups, though the cooled babies still came out on top.

A total of 24 of the 69 treated with the cooling method (35 percent) and 19 of the 50 who received routine care (38 percent) had a moderate or severe disability. The rates of cerebral palsy, blindness and epilepsy were similar across both groups.

“This follow-up study confirms the original finding, showing that children who received the cooling treatment were more likely to survive, and that the survivors were no more likely to have a disability than the children in the untreated group,” said senior author Rosemary D. Higgins, MD, of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Studies with larger groups will yield more information, but the research team has determined that this hypothermia treatment is among the best treatment options for babies who can't get enough oxygen immediately after birth.

“Before the advent of this cooling treatment in 2005, doctors couldn’t treat hypoxic ischemic encephalopathy, and many infants died or sustained brain injury,” Dr. Shankaran said. “It’s reassuring to see that the benefits of this practice, which have been widely documented at 18 months or 2 years of age, are apparent as these children grow.”

The study appeared online May 31 in the New England Journal of Medicine. The research was part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. It was funded by the National Institutes of Health's National Center for Research Resources and the National Center for Advancing Translational Sciences.

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Review Date: 
June 6, 2012