Perinatal asphyxia – Brain injury at birth

Perinatal asphyxia – Brain injury at birth 

Perinatal asphyxia, also known as hypoxic-ischemic encephalopathy (HIE), causes acute or subacute brain injury due to asphyxia.
Earlier, no significant treatment was available for HIE. Later with research evidences, they found cooling baby’s brain reduces the metabolic rate of cells, in turn reducing brain damage. This can be achieved if treatment begins within 6 hours of birth.
HIE - Perinatal asphyxia - Brain injury at birth

Qualification of baby for hypothermia treatment:
Any term baby suffering from perinatal asphyxia with qualified APGAR score are eligible for hypothermia treatment.
Apart from this, various tests and symptoms indicate baby might have HIE.

  • Meconium-stained amniotic fluid
  • Low heart rate
  • Poor muscle tone
  • Weak breathing or no breathing at all
  • Bluish or pale skin color
  • Excessive acid in the blood

Also CT scan, MRI scan, echocardiography, and ultrasound are taken for confirmation. Optional tests may include electrocardiogram (EKG), electroencephalogram (EEG).

 Treatment:
Immediate treatment for infants born with HIE involves cooling the baby for three days. Few degree drop in temperature result in significant less brain injury.
The baby will be placed on a cooling blanket for three days and are closely monitored for any signs of discomfort.

The treatment usually involves head cooling or total body cooling. Initially they started with head cooling, down the line they concluded the deeper parts of brain didn’t receive proper cooling leading to brain damage. Later they discovered, whole body cooling is much effective compared to selective head cooling.

Monitoring during treatment:
While baby is under treatment, baby is constantly monitored.
They check heart rate, breathing pattern, temperature along with monitoring of brain activity with EEG and with cerebral function monitor (CFM).

During the cooling period, it is normal for your baby to have a slower heart rate and breathing rate, and to appear quiet and sleepy. Baby will receive nutrition through intravenous (IV) therapy.

Treatment cycle:
1) Rapid cooling – cool the baby to 33.5 ˚ – 34.5˚ from 37.5˚.
2) Constant temperature phase – maintain the temperature for 72 hours
3) Slow re -warming: Increase baby temperate by 0.1˚ to 0.2˚ per hour till it reaches 37˚.
4) Monitor the baby for next 24 hours for thermal maintainence.

Introducing Brammi..

We are gratified to see how well clinicians are taking efforts to save these precious lives. Contributing to HIE therapy, Phoenix came up with ingenious servo controlled cooling system – “Brammi”. The unit is designed in such a way complete treatment cycle is taken care. The system maintains 33.5˚ for 72 hours and immediately starts rewarming at pace of 0.1˚ to 0.5˚
Brammi’s intuitive feature helps to closely monitor baby with graphical representation of data and comes with safety parameters. The patient data along with name can be ported out through USB. Understanding the treatment has to start within 6 hours of birth, the unit is built light weight (portable) with 3 hour battery back up for easy transportation. Cool the baby, anytime – anywhere.

For more information on Brammi please contact any phoenix representative.
Source : ncbi.