An Ancient Remedy for Modern Babies: Hypothermia

Pediatric neurologist Kevin Joseph, D.O., examines scans of infant brains. Joseph is part of the Valley Medical Center team that uses hypothermia to treat babies with neonatal encephalopathy.
Photo courtesy of Kelley Balcomb-Bartok and Valley Medical Center.

The concept of using hypothermia as a medical therapy has been around for at least 5,000 years. Its popularity in treating various conditions has fluctuated throughout history, but, in the last decade, it has gained significant traction in treating babies with neonatal encephalopathy. Today, whole-body hypothermia is a standard of care in many Level III neonatal intensive care units (NICUs) — including the NICU at Valley Medical Center, a hospital in the UW Medicine system.

It is estimated that two to nine out of every 1,000 infants are born with neonatal encephalopathy, a disturbance in neurological function caused by oxygen loss. The condition carries a high risk of mortality, developmental delays and permanent brain injury. However, studies in the last decade have shown that lowering an infant’s core body temperature to 33–35 degrees Celsius (or 91.4–95 degrees Fahrenheit) — for approximately 72 hours within six hours of birth — improves a child’s life expectancy and neurocognitive outcomes.

“It seems like such a simple thing to do to cool the body down by a few degrees,” says Kevin Joseph, D.O., a pediatric neurologist at Valley Medical Center. “And it’s amazing that it can save lives and make the difference between a low IQ and a normal IQ.”

When an infant’s brain experiences a sudden loss of blood supply and oxygen, neurons begin to die, and excitotoxic injury results, increasing the likelihood of brain damage. “Hypothermia slows this process down and gives the brain the opportunity to heal and recover,” Joseph explains. It also decreases the severity of seizures, which often occur in infants with this condition.

Valley’s state-of-the-art NICU is complete with video EEG monitoring, a world-class team of neonatologists and nurse practitioners, and the ability to offer hypothermia treatment on site at a moment’s notice. So far, the team has treated two infants using hypothermia, and both cases went smoothly.

“To be able to offer this to the south King County community is really amazing,” Joseph says.

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