Summary/Conclusions

Whether it is called brain cooling, therapeutic hypothermia or neural rescue, it appears that this technique is becoming more prevalent and growing in acceptance. Soon, it could become the standard of care for those born with HIE. The simplicity that attracted empyricists to cooling centuries ago now makes hypothermic neural rescue a potentially transforming therapy when birth asphyxia remains a major cause of death and disability.

Children born with HIE could benefit from brain or whole0body cooling if awareness of the technology is raised. While most neonatologists are aware of this practice, general practitioners are less knowledgeable about the recent studies and advances in this area. And because the cool-cap technology is relatively new, it will take time to evaluate its effectiveness and success.

While this is still an evolving therapy, studies have demonstrated that it is both safe and effective. In fact, in a small number of experienced tertiary centers, it has become a standard of care.

Any time a baby is born with prenatal asphyxia, it should be a red flag for doctors to immediately contact a facility that uses the cool-cap because the treatment window is approximately six hours.

However, keep in mind that many doctors caution that this technique is still experimental and may not work for all babies. Those who have received this treatment will be monitored for years to study effects and their long-term health.

Whatever advances and breakthroughs have been made are the direct results of studies that began decades ago. This 20+-year body of research, for the first time, gives very strong indications that cooling can be effective in reducing brain damage after birth asphyxia. Even though it doesn't work in every instance, studies show the percentage of babies who survived without signs of brain damage went from 28% to 44%-a 57% increase-with cooling treatments.

Again, because this technique is in its infancy-in terms of medical treatment-the full effects will not be totally known for years, maybe decades. However, the process itself seems to carry no risks, and currently is the only alternative to doing nothing.

If there is a consensus it is that the medical community seems to agree that therapeutic hypothermia is better than standard intensive care treatments at reducing the risks for carefully selected newborn babies who have been deprived of oxygen. It has been shown to decrease their chances of dying or developing severe neurological damage.

The technique has won backing from the National Institute for Health and Clinical Excellence, with the advisory that brain cooling should only be performed by specially trained staff experienced in caring for severely ill babies.

In conclusion, brain cooling is not a miracle cure, but it is a treatment that can help the most serious consequences in some newborns. At a minimum it gives hope to parents of some of the sickest babies, and that is infinitely more than they have ever had before.

With this hope, unfortunately, also comes missed opportunities. When a physician fails to take action to prevent or adequately treat a medical complication that leads to HIE, they sometimes can be held liable for all related damages. This is when you need a compassionate and aggressive attorney to work on your behalf. Dr. Bruce G. Fagel is an attorney who is also a licensed physician. Call him at (800) 541-9376 to discuss your case.