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

Understanding the Concept of Neuroprotection

Understanding the previously described background of hypoxia and the resultant systemic insult to the infant leads to better understanding of the concept of neuroprotection and the efforts underway to halt or lessen the evolution of the insult. Neuroprotection is defined as the mechanisms and strategies provided to a patient to protect against neuronal injury or the degeneration of the central nervous system (CNS) after an acute event or disorder. The goal of neuroprotection is to limit damage from the acute injury and provide care in an attempt to maintain the highest possible integrity of cellular functions and interactions.[14] This definition clearly aligns with our description of hypothermia for the neonate after perinatal asphyxia and HIE.

Hypothermia is defined as abnormally low core body temperature (<35°C) to a level at which normal metabolic, muscular, and cerebral functions are impaired.[30] The idea of hypothermia has been a suggested treatment after hypoxic injury for decades. Through earlier described progression of animal model research, then pilot studies with human subject including feasibility data, the science moved to randomized clinical trials using multiple treatment sites and large samples. Earlier studies have been replicated both to verify findings and to "fine tune" both inclusion criteria for study participants as well as scientific rationale for temperature and duration of hypothermia.

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