Caps are a cool idea in preventing brain damage

Their numbers may be small, but for that one baby out of every 1,000 who suffers from brain damage due to lack of blood flow or lack of oxygen during birth, the effects can be enormous.

By Craig Hilborn

For The Courier-Herald

Their numbers may be small, but for that one baby out of every 1,000 who suffers from brain damage due to lack of blood flow or lack of oxygen during birth, the effects can be enormous. These issues can happen if the cord is in the wrong position, if the placenta comes loose from the uterus or if the uterus tears. Most of the time, it’s a situation doctors say they cannot predict or prevent.

Often, babies who are born with brain insult – which means the interruption of blood flow or oxygen to the brain during labor or delivery – do not survive. Those who have managed to survive were likely to suffer from disabilities like cerebral palsy, epilepsy or learning disabilities…until now.

In May, MultiCare Tacoma General Hospital began using the Olympic Cool-Cap System. This system is used for the treatment of moderate to severe injury to brain tissue (hypoxic-ischemic encephalopathy, or HIE) as a result of insufficient oxygen delivery to the brain prior to or during delivery.

The system consists of a cerebral function monitor and the Cool-Cap. The monitor is used during the physical assessment by a neonatalogist, a pediatrician specializing in the care of newborns, and can measure the severity of the brain injury to determine the eligibility for treatment with the Cool-Cap system within the first six hours of birth.

The Cool-Cap has a mobile unit that supplies cooled water to a cap placed on the infant’s head. Water is cooled with a thermostatically controlled cooler and circulated through the cap by an electrical pump and plastic tubing. The temperature of the cap is monitored and controlled to a user specified temperature within 0.1 degree Celsius to cool the infant’s head while maintaining core body temperature at safe levels. After exactly 72 hours of selective head cooling, the cap is removed and the infant is allowed to re-warm to normal body temperature.

SHC does not treat the initial brain injury. However SHC, initiated within six hours after birth, has been shown to significantly reduce secondary brain injury. The sooner the cap goes on, the greater the chance of reducing brain injury. The results of SHC can’t be determined until babies are around 18 months of age.

The Cool-Cap system is the only FDA approved device for the treatment of brain injury in full-term infants and is the first treatment which has been shown to result in meaningful improvements in neurodevelopmental outcomes, giving hope to families that in the past were given very little.

For more information on Tacoma General’s Neonatal Intensive Care Unit, visit multicare.org.

Craig Hilborn is supervisor of the Neonatal Intensive Care Unit at MultiCare Tacoma General Hospital.

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