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Therapy for Babies: Hypothermia device helps save infants from brain damage

M. Paul Jackson
March 18, 2006

Everything was going fine for heavily pregnant Christi Wall. But then her baby stopped kicking.

The baby wasn't getting enough oxygen and was at risk of brain damage, said Wall of Pinnacle. Doctors at Forsyth Medical Center delivered her daughter Anna by emergency Caesarean section and treated Anna's asphyxia by lowering her body temperature.

This helped protect Anna from possible brain damage from the asphyxia, doctors said.

Hospitals are using more radical therapies such as hypothermia treatment to treat babies, doctors said. Other new treatments proving successful include the use of robotic devices and more microsurgery equipment.

The hypothermia therapy, developed for children late last year, "is really the first effective treatment" for children with asphyxia, or a lack of oxygen, said Robert Dillard, the director of the Neonatal Intensive Care Unit at Forsyth Medical Center. "It's really a major step for this group of babies," he said. Dillard is also a professor of neonatology at Wake Forest.

Asphyxia in newborns occurs when the body receives too little oxygen before birth. It can damage the brain, heart, blood vessels and kidneys. It can be caused by inadequate oxygen in the mother's blood or poor oxygen circulation to the placenta.

Forsyth Medical Center, Brenner's Children's Hospital, part of Wake Forest University Baptist Medical Center, and Duke University School of Medicine are the only three state medical centers using the therapy, physicians said. Forsyth Medical Center has so far treated two children using the hypothermia therapy, Dillard said.

Forsyth Medical Center and Wake Forest collaborate on neonatology services.

Using hypothermia is a significant departure from how physicians were treating asphyxia, said Michael O'Shea, the chief of the medical center's neonatology division. The medical center had been treating the condition partly by warming babies with a radiator.

Cooling the body reduces swelling of the brain, Dillard said. The procedure was reported in the New England Journal of Medicine late last year and adopted in the hospital shortly after.

The device, the Blanketrol II Hyper-Hypothermia System, is made by Cincinnati Sub-Zero Products Inc., in Ohio. It involves wrapping a baby in a cooling blanket and lowering its body temperature to about 92 degrees.

"It's certainly very exciting and likely to prevent some of the cases of cerebral palsy that could occur" in children with asphyxia, O'Shea said.

Christi Wall's daughter, born Dec. 26, initially had no heartbeat, she said. "I didn't hear her cry," Wall said. "I knew something wasn't right. I knew if I heard her cry, she would be OK."

The hospital's staff revived Anna, but feared that the lack of oxygen to her brain would cause serious complications. She was put inside the Blanketrol II for 72 hours.

After praying in the hospital "we kept a pretty positive attitude and kept believing for the best and day by day we kept getting good news," said Cliff Wall, Christi's husband.

Fifteen days after her birth, Anna was allowed to leave the hospital, Christi Wall said. Anna must still undergo regular checkups, but seems to be doing fine, she said.

The therapy is just one of the new ways doctors hope to treat very small children. They predict that advancing medical technology will allow them to perform better surgeries on babies, particularly noninvasive surgeries. Also, more equipment and medical circuitry is being miniaturized for use in children, O'Shea said. "Each generation of neonatalogists believe we have gone as far as we can go, and then something happens to change the technology," Dillard said.

"Right now, we're saying 'we've gone as far as we can go.'"

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