Brain Cooling for Treatment of HIE

Alternative names

Cooling

Definition

The only brain-specific therapy for HIE that has been proven to reduce the risk of long-term neurodevelopmental handicaps is brain or whole body hypothermia (cooling the infant’s body temperature by 3-4 degrees to approximately 33.5 degrees Celsius or 92 degrees Fahrenheit).

Why the procedure is performed

Currently, the only brain-specific therapy that has been proven to reduce the risk of long-term neurodevelopmental handicaps is brain or whole body hypothermia (cooling the infant’s body temperature to approximately 33.5 degrees Celsius or 92 degrees Fahrenheit) for 3 days.

Risks

To date, clinical trials involving more than 550 infants have been published to assess the benefit of cooling for HIE. These trials have demonstrated that cooling for brain protection in infants with moderate to severe HIE is both beneficial and safe. However, in these trials, some noted potential side effects of cooling were skin changes that resolved in time, more use of blood pressure medications, and a slight decrease in the blood’s ability to clot.

Before the procedure

What infants qualify for cooling?

  • Infants with moderate to severe HIE, not mild cases.
  • The infant cannot have another cause of brain dysfunction such as a brain malformation or bleeding into the brain.
  • Only infants that are less than 6 hours old. Laboratory studies show that after 6 hours of life, there appears to be no benefit in cooling for HIE.

Outlook (Prognosis)

Does cooling help all infants with HIE?

Unfortunately, cooling only helps approximately 1 in 8 babies with moderate to severe HIE. At this time, when a physician starts the cooling process it is impossible to know which babies will benefit from cooling and which babies will not. Further research is currently ongoing in this area.