Therapy Puts Chill On Brain Injuries
A process called total body hyothermia, or total body cooling, could slow the process of brain damage in babies who suffer oxygen deprivation by slowing the brain's metabolism.
Dr. Sue Hall says putting a chill in babies who've been deprived of oxygen during labor or delivery could save their brains.
Hall, medical director of the neonatal intensive care unit at Topeka's Stormont-Vail HealthCare, says a whole set of things happen when oxygen has been low. Mainly, different chemicals are released that ultimately injure cellular functioning.
A process called total body hyothermia, or total body cooling, could slow that process by slowing the brain's metabolism. Hall says it's thought that slowing the metabolism makes the brain more resistant to injury from the chemicals.
The theory came from studying near-drowning victims who fell into the icy waters of Scandanavian countries. Instead of becoming brain-dead after long periods of being submerged, they recovered to function normally, it's thought, because the brain had been kept cool.
As applied in the hospital setting, babies are put on a cooling blanket that keeps their body temperature at 92 degrees for 72 hours. They are then gradually warmed back up over another 12 hour period.
But the process must be started soon. Hall says here's just a six-hour window from the time of oxygen deprivation to the time brain cells start to die. Realizing the potential benefits, staff at Stormont's NICU was trained and began offering the procedure in November. Before that, infants who were candidates for total body cooling would be sent to Kansas City. Hall says even that trip would cost precious minutes.
"Time equals brain cells," she said.
The procedure is targeted at full-time babies - not preemies - who suffer some event during labor or delivery that deprives them of oxygen and puts them at risk for brain injury, such as a maternal hemorrhage, placenta separation or compressed umbilical cord. Hall says babies who suffer this type of oxygen deprivation had a 66 percent chance of dying or having moderate or severe developmental problems. The cooling therapy lowers that to 44 percent.
Hall says it's not a cure for every single baby, but it's the only treatment they have to offer.
Hall says Stormont has used the treatment on four babies already with good results.
Incidentally, the same treatment is used to prevent brain damage in adult heart attack patients who've been deprived of oxygen for a length of time.
Reporter: Melissa Brunner
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