Healthy Life: Life Saving "Cool Wrap" for Babies
BACKGROUND: Therapeutic hypothermia involves lowering a newborn’s body temperature from a standard 37 degrees to 33.5 degrees. Cooling wraps that circulate cool water are placed around a newborn’s arms and trunk area. After three days, babies are slowly warmed over a 24-hour-period. In addition to cooling the baby, continuous brain monitoring and neurological consultation with early rehabilitation services occur with all high-risk infants in the neonatal intensive care unit (NICU) to assist in optimal care and outcome. (SOURCE: http://www.stlouischildrens.org)
NEW FINDINGS: A four-year randomized, controlled trial of 400 newborns at five centers around the world has yielded parallel findings of benefit from therapeutic hypothermia that rendered this treatment as a standard of care in many Level 3 Newborn ICUs. Doctors at St. Louis Children’s Hospital have already altered the outcomes of many poor-performing newborns. They’ve found that therapeutic hypothermia can reduce the chance of severe brain injury by 25 percent in term-born babies with poor transition or low Apgar scores after birth. It is very important that these babies are given the cooling treatment as soon as possible because it appears the treatment may not work as well after the first few hours of life. (SOURCE: http://www.stlouischildrens.org)
THE PROCESS: At St. Louis Children’s Hospital, when concern of a brain injury is present, early referral and evaluation are suggested. Doctors advise the referring team on how to manage the temperature of the baby until the arrival of the transport team, who then initiates the cooling process in route. As soon as the baby is admitted to the neonatal unit, the team transfers him or her to a different type of cooling device. It’s been shown that the earlier neuro-protective therapy begins, the more benefit a baby will experience. (SOURCE: http://www.stlouischildrens.org)
TREATMENT INDICATIONS: Doctors at St. Louis Children’s Hospital advise that obstetricians and pediatricians should be alert to the following risk factors:
• Concerns about a baby prior to delivery, including heart rate abnormalities or meconium in the fluid.
• A difficult delivery; for example, shoulder dystocia or the presence of placental bleeding.
• Extra support to establish breathing and a good heart rate following delivery.
• Accumulation of acid in a blood sample from the baby’s cord or the baby after birth.
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Washington University School of Medicine in St. Louis
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