Nursing Voices

Tuesday, January 16, 2007

This is So Cool.

Pun intended.

(WARNING: highly educational and seriously UNfunny post to follow.)

In this age of technology and gadgets, it's not often that a revolutionary breakthrough utilizes basic physiology to make a miraculous difference.

Brain cooling is an amazing new (relatively speaking) technique being offered by several NICUs across the nation, and unfortunately, we've had a few babes over the last year that have needed it. Fortunately, it can work.

I was thinking about these kiddos the other day, which led me to do a little surfing in search of further information.

Brain cooling is intended for infants that have undergone hypoxic injury related to labor or delivery, with events such as abruption, ruptured uterus or cord prolapse or occlusion. This article, from Georgetown University Hospital, discusses the pathology of hypoxic-ischemic encephalopathy (HIE) and how brain cooling is used to try to avoid what was described to me as the "second wave" of brain damage that occurs following the hypoxic event.

While specific processes differ slightly, most sources agree that the cooling must be initiated within six hours of birth and bring the infant to a hypothermic state (around 91 degrees Fahrenheit!), slowing down the body's metabolic processes to avoid further chemical and inflammatory damage to the brain tissue. After 72 hours, the infant is then slowly rewarmed.

It is by no means the perfect miracle cure. This article, from the BBC, suggests that it results in significant improvement in outcomes for only one out of every six to eight babies that undergo the treatment and is unlikely to make a difference for those with the most severe brain injuries. However, that is still 12-16% of these deathly ill infants who may now have a chance for recovery.

Here is a short video documenting one such case.

What can I say?

So cool.


Labor Nurse said...

Isn't it fascinating? I just heard of brain warming this past weekend. I believe it is also something that my hospital hopes to do.

Thanks for the links.

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