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Treating Hypoxic-Ischemic Encephalopathy (HIE) with Therapeutic Hypothermia (Cooling Therapy)

Hypoxic-ischemic encephalopathy (HIE) is an injury that can occur during birth. It is characterized by oxygen deprivation in an infant’s brain, caused by limited blood flow. Untreated HIE can cause severe brain damage and the development of disabilities.

An option for HIE treatment is a procedure known as therapeutic hypothermia, or cooling therapy. If a doctor uses cooling therapy during the first 6 to 12 hours following a hypoxic-ischemic encephalopathy injury, the treatment can reduce potential harm.

Benefits of Cooling Therapy

Hypoxic-ischemic encephalopathy can damage gray matter, which contributes to the brain’s control of movement, the senses, and decision making. Cooling therapy that is administered promptly can reduce gray matter irregularities in infants who sustained an HIE injury during birth. With cooling therapy, the reduction of gray matter damage can limit the severity of HIE-associated disabilities such as seizures, cognitive and developmental limitations, and cerebral palsy.

About the Cooling Therapy Process

During cooling therapy, the injured baby’s temperature is reduced to limit blood flow and decrease swelling. Cooling therapy can target just the head (“selective head cooling”) or the entire body (“whole-body cooling”). Selective head cooling reduces the infant’s temperature to around 94.1 to 95 degrees Fahrenheit, often with a cooling cap. When whole-body cooling therapy is administered through the use of a blanket, the temperature is reduced to 92.3 to 93.2 degrees Fahrenheit. Either form of therapeutic hypothermia can last up to 72 hours, after which the baby is warmed back to the typical human body temperature of 98.6 degrees Fahrenheit. The temperature reduction allows damaged cells to recover and prevents further damage to the baby’s brain.

Cooling Therapy Eligibility

Doctors who are equipped to administer cooling therapy must check to see that the baby meets certain criteria beyond the hypoxic-ischemic encephalopathy injury. The additional criteria for cooling therapy can differ from hospital to hospital.

A doctor who is considering treating an infant with cooling therapy may check for:

  • A gestational age of at least 36 weeks
  • Abnormal EEG
  • Blood cord pH of 7.0 or less
  • An APGAR score under 5
  • If breathing assistance was needed for at least 10 minutes during the birth
  • A brain exam that exhibits damage
  • Bladder, kidney, or liver malfunction

Hypoxic-ischemic encephalopathy can be caused by a doctor’s negligence, although other factors can contribute to HIE. If HIE does occur during birth, a doctor’s failure to quickly administer cooling therapy to an eligible patient could be evidence of further negligence and a potential birth injury legal claim.

The Cullan & Cullan legal team includes four lawyers who are also doctors. We have reviewed hundreds of birth injury cases over the last thirty years, giving us an informed perspective on birth injury case litigation. Contact us if medical negligence caused an injury such as hypoxic-ischemic encephalopathy in your child.

Send us a message or call (602) 900-9483 to schedule a free consultation with our attorneys.


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