Whole Body Cooling
Our first instinct upon seeing a baby is to pick her up and swaddle her in a blanket. But for some babies at Jefferson Abington Hospital, the exact opposite of care is needed.
The staff of the Andrew Tesauro Special Care Nursery (NICU) provides whole body hypothermia to certain infants who have been through a traumatic birth and experienced reduced levels of oxygen or blood flow to their brains or bodies. This treatment can preserve cells and decrease ongoing damage to the brain.
Infants with moderate or severe Hypoxic-Ischemic Encephalopathy (or HIE) have to be cooled within six hours of birth to a body temperature between 33.5°C and 34.5°C (or 92 degrees Fahrenheit). This temperature has to be maintained without interruption for 72 hours. The cooling is done slowly and safely. The procedure involves EEG monitoring, a cooling apparatus and a rectal thermometer for constant monitoring of the baby’s temperature.
The 72-hour cooling is followed by slow re-warming over a period of at least four hours at a rate of 0.5°C per hour until the baby’s rectal temperature reaches the desired range (36.5-37°C).
Babies can be treated with whole body hypothermia if they are 35 weeks old or older. The current evidence does not support cooling of infants with mild HIE or those born before 35 weeks.
“This treatment helps preserve the cells and decreases ongoing damage to the brain,” said Gerry Cleary, MD, medical director, Andrew Tesauro Special Care Nursery. “It could reduce death and disability in babies with encephalopathy and is a very important treatment to have available in a hospital which delivers as many babies as Abington.”
The staff of the Andrew Tesauro Special Care Nursery includes board certified neonatologists who care for babies around-the-clock. Neonatologists are in the NICU every day of the week, 24/7, should they be needed in the middle of the night or whenever one of our tiniest patients needs them.
Neonatologists work closely with their experienced nursing staff and the parents of their patients. “We talk to the families every day,” said Dr. Cleary, “so they can understand everything we are doing to help their babies get healthy enough to go home to their families.”