Hypoxic-ischaemic encephalopathy begins when a baby is deprived of oxygen around the time of birth. The initial injury starts during oxygen deprivation. The damaged cells release toxic substances that injure surrounding healthy brain tissue in the hours following resuscitation and restoration of blood flow and oxygen. This secondary phase represents a window of opportunity because it can be interrupted.
Therapeutic hypothermia can reduce the extent of brain injury following perinatal asphyxia. The biochemical process resulting in secondary injury is slowed by lowering the baby's core body temperature to thirty-three to thirty-four degrees Celsius for seventy-two hours. It reduces the extent of brain damage and improves neurological outcomes for affected newborns.
At KIMS Cuddles at KIMS Hospitals, Electronic City, therapeutic hypothermia in neonatal care at Electronic City, Bengaluru is provided using a servo-controlled cooling machine that maintains the baby's temperature with the precision required for safe and effective treatment, for families across Electronic City, Hosur Road, Sarjapur Road, and South Bengaluru.
Who Therapeutic Hypothermia Is For
Cooling therapy for newborns in Electronic City is for term and near-term newborns who have experienced perinatal asphyxia and show signs of moderate to severe hypoxic-ischaemic encephalopathy. The specific criteria include:
- Gestational age of thirty-six weeks or above
- There is oxygen deprivation, including the need for resuscitation at birth, low Apgar scores, or a sentinel event such as cord prolapse or placental abruption
- Neurological signs of encephalopathy include abnormal tone, reduced level of consciousness, seizures, or feeding difficulty
- Abnormal amplitude-integrated EEG findings consistent with moderate or severe encephalopathy
Treatment must begin within six hours of birth to be effective, which is why the recognition of eligible babies and the rapid initiation of cooling are time-critical clinical priorities in our NICU.
The Servo-Controlled Cooling Machine
Our servo-controlled cooling NICU in the Electronic City system uses a water-filled blanket placed beneath the baby and a pump unit that circulates cooled water through the blanket at a precisely controlled temperature. The servo-control function continuously measures the baby's rectal temperature. It automatically adjusts the water temperature in the blanket to maintain the baby's core temperature of thirty-three to thirty-four degrees Celsius throughout the seventy-two hour treatment period.
The automatic temperature management is critical for the treatment to work and for safety. Manual cooling methods, including ice packs or passive cooling, cannot achieve the degree of temperature precision required and carry the risk of overcooling, where the baby's temperature falls below the safe range, which can cause cardiac arrhythmias, coagulation disturbances, and increased infection risk.
During the Cooling Period
The seventy-two hours of neonatal hypothermia treatment require close, continuous monitoring and active management of the multiple physiological effects that therapeutic cooling produces.
It is expected for the heart rate to fall during cooling, and well tolerated by many newborns. But it requires continuous cardiac monitoring to identify arrhythmia. Blood glucose also requires continuous monitoring during cooling with appropriate glucose supplementation. Coagulation may be affected, which requires assessment and treatment when needed. Doctors offer pain management during cooling through appropriate analgesic and sedation protocols.
Seizures are common in babies with hypoxic-ischaemic encephalopathy, and their detection and management during cooling require amplitude-integrated EEG monitoring alongside the clinical assessment, which our team provides as a standard component of cooling care.
Rewarming
The baby is rewarmed slowly, which takes around six to eight hours after seventy-two hours of cooling. The servo-controlled system manages the temperature rise to avoid rebound hyperthermia, which can make neurological outcomes worse.
Doctors closely observe the baby's condition during rewarming because seizures can increase with the rise in temperature. Heart rate and glucose also require reassessment as the metabolic effects of cooling can reverse.
Brain Imaging After Cooling
MRI brain imaging is performed after cooling is complete, typically at around a week of age, to check the extent of brain injury and provide prognostic information. The pattern of injury on MRI correlates with neurological outcome and guides the planning of developmental follow-up and early intervention.
Long-Term Follow-Up
Babies who have received therapeutic hypothermia become a part of our high-risk neonatal follow-up programme. It allows developmental assessments at regular intervals through infancy and early childhood. Early identification of developmental concerns allows timely referral for physiotherapy, occupational therapy, and other supports, improving functional outcomes for affected children.
Why Choose KIMS Cuddles at KIMS Hospitals, Electronic City
Therapeutic hypothermia requires a neonatal team trained in its administration, a servo-controlled cooling system with accurate temperature control, and the monitoring infrastructure to safely manage the physiological complexities of the cooling period. At KIMS Cuddles at KIMS Hospitals, Electronic City, all of these are available in a fully equipped NICU in South Bengaluru, ensuring that eligible babies are able to receive this time critical treatment without the need to transfer to a distant facility.
Contact Our Team
If you have a newborn who has experienced perinatal asphyxia and may be eligible for therapeutic hypothermia, contact KIMS Cuddles at KIMS Hospitals, Electronic City, immediately. Our neonatal team is available around the clock to provide the necessary services.
