Neonatal Hypothermia

A Method to Provide Neuroprotection After Hypoxic Ischemic Encephalopathy

Katherine M. Newnam, MS, RN, CPNP, NNP-BC; Donna L. DeLoach, MS, RN, CPNP, NNP-BC

Disclosures

NAINR. 2011;11(3):113-124. 

In This Article

Parental Concerns

The management of these very sick infants requires attention to detail to affect the best outcomes. However, the nursing role extends to providing education and support to the family about both the intervention as well as "emotional support as the prognosis evolves."[4] Robertson et al[43] refer to the hopelessness of the infant with HIE before the availability of cooling therapy. In spite of encouraging data from follow-up studies on the benefits of hypothermia, the severity of the initial hypoxic injury is most prognostic of the infant's outcome, and those infants with a moderate degree of encephalopathy are the most difficult for predicting outcomes.[4,9] The availability of the aEEG has afforded earlier insight into possible neurodevelopmental outcomes and response to intervention.[34,35] Involving the parents in the hospitalized infant's care will encourage bonding, and touch even during the acute phase of injury should be encouraged. As soon as the infant is medically stable, supportive therapies such as physical therapy, occupational therapy, and speech therapy can be initiated. Parental concerns are acknowledged but not discussed in the medical literature. Families would better served with a better understanding of their fears, concerns, and struggles, which would be best addressed by the nursing staff working closely with them. Advance practice nurses should embrace the opportunity to reach out to these families, describing as well knowing the hospital course is just the beginning of a life-long journey for those children most affected by HIE.

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