April 26, 2010
Anything that save’s a baby’s life warrants the public’s attention. A few months back, I had a conversation with a New York colleague who raved about a new method that helped prevent brain injury of newborns. When I inquired further, she stated that a baby with an APGAR score of 1 after five minutes had escaped permanent brain injury through the use of a “cooling blanket.”
Anyone who is remotely familiar with obstetrics knows that the APGAR score is a useful tool for determining the newborn’s status shortly after it is born. APGAR scores were developed by Dr. Virginia Apgar, a Columbia University trained anesthesiologist and evaluates the baby’s heart rate, muscle tone, respiratory rate, reflex response and color at one and five minutes of life. Each criterion is given either 0, 1 or 2 points. An APGAR score of 0 to 3 after five minutes is suspicious for a birth brain injury.
When the baby does not receive enough oxygen in the womb, its brain cells becomes damaged causing permanent injury. However, that dismal prognosis has begun to change, thanks to hypothermia (cooling) therapy. According to a large medical study called Cochrane, “. . . parents should expect that cooling will decrease their baby’s chance of dying, and that if their baby survives, cooling will decrease his/her chance of major disability.” What a MAJOR breakthrough in medical science and a reason to celebrate for expectant parents.
One of the first institutions to use this method was the University of California at San Francisco. I contacted the nurse in charge of the program and she was kind enough to share their protocol. In order for the cooling method to work, it must be used within the first six hours of life. Here’s how it works:
- Your baby must be 36 weeks or greater
- Must have an APGAR score of less than 5 at 10 minutes
- Must have received chest compressions and/or intubated or received a mask helping it to breathe at 10 minutes of life
- Have a low blood gas within the first 60 minutes of life
- Have signs suggesting HIE which include having a seizure, poor muscle tone, poor feeding or be in a coma.
Although the cooling method is expected to become the standard of care in the future, there are hospitals that are already using it. Does your hospital use hypothermia? The answer could save your baby’s life.