When a baby is deprived of oxygen around the time of birth, a sequence of events begins that does not end with the restoration of breathing and circulation. The initial injury, caused by the period of oxygen deprivation itself, is followed hours later by a second wave of neurological damage driven by the inflammatory and biochemical cascade that the injury triggers. This secondary phase is when the most damaging processes occur, and it is also the window of opportunity that modern medicine has learned to exploit.
Therapeutic hypothermia is the only intervention proven to interrupt this secondary injury cascade and reduce the extent of permanent brain damage following perinatal asphyxia. By reducing the baby's core body temperature to thirty-three to thirty-four degrees Celsius for seventy-two hours, the metabolic processes driving secondary injury are slowed, inflammatory mediators are suppressed, and the brain is given the conditions in which it can recover as much function as possible.
At KIMS Cuddles at KIMS Hospitals, Mahadevapura, therapeutic hypothermia for neonates in Mahadevapura, Bengaluru is provided using a servo-controlled cooling system that maintains the baby's temperature with the precision that safe and effective treatment requires. For families across Mahadevapura, Whitefield, and East Bengaluru, this specialist treatment is available locally within our neonatal intensive care unit.
Who Therapeutic Hypothermia Is For
Cooling therapy for newborns in Bengaluru is recommended for term and near-term newborns who have suffered from substantial perinatal asphyxia and have moderate to severe hypoxic-ischaemic encephalopathy. Specific criteria include:
- The child is thirty-six weeks or older
- Has a history of a significant perinatal event which may have been due to oxygen deprivation
- Exhibits neurological signs of encephalopathy (abnormal tone, reduced consciousness, seizures, or feeding difficulty)
- Has abnormal EEG amplitude-integrated EEG consistent with moderate or severe encephalopathy.
Treatment must begin within six hours of birth to be effective. Recognising eligible babies quickly and initiating cooling without delay is therefore one of the most time-sensitive clinical priorities in our NICU.
Our team is trained to identify eligible babies promptly and begin cooling as soon as the criteria are met, without waiting for a full diagnostic workup that would introduce harmful delay.
The Servo-Controlled Cooling System
Our neonatal brain cooling service in Bengaluru 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 and automatically adjusts the water temperature to maintain the core temperature at the target of thirty-three to thirty-four degrees Celsius throughout the seventy-two hour treatment period.
This automated servo-controlled approach is what distinguishes effective therapeutic hypothermia from dangerous cooling. The level of temperature control required cannot be achieved with manual cooling techniques such as ice packs or passive cooling and there is a risk of overcooling, where the baby’s temperature drops below the safe range.
Too much cooling can cause problems with heart rhythm, blood clotting and an increased risk of infection. The servo-controlled machine eliminates this risk by responding to the baby's actual temperature in real time rather than relying on manual checks and adjustments.
During the Cooling Period
The seventy-two hours of hypoxic ischaemic encephalopathy treatment in Bengaluru require close monitoring and active management of the multiple physiological effects that therapeutic cooling produces. Heart rate falls during cooling, which is expected and generally well tolerated, but requires continuous cardiac monitoring to identify any significant arrhythmia.
During the cooling process blood glucose is more labile and requires frequent monitoring with appropriate supplementation. Coagulation may be impaired and may need to be assessed and corrected as required.
Seizures are common in babies with hypoxic-ischaemic encephalopathy and their detection and management during cooling requires amplitude-integrated EEG monitoring in addition to clinical assessment. Throughout the cooling period, aEEG is continuously monitored by the team to ensure early recognition and treatment of seizures, even in the absence of clinical signs.
Rewarming
After seventy-two hours of cooling, the baby is gradually rewarmed over approximately six to eight hours, with the servo-controlled system managing the rate of temperature rise to avoid rebound hyperthermia.
Seizures may increase in frequency with increasing temperature and physiological parameters need to be reassessed as the metabolic effects of cooling reverse, so the baby is closely monitored by the clinical team during rewarming.
Brain Imaging and Long-Term Follow-Up
After cooling, MRI brain imaging is performed about a week of age to determine pattern and severity of brain injury and give prognosis to family. Therapeutic hypothermia patients are followed with developmental assessments of the baby's development using a structured scale at regular intervals throughout infancy and early childhood in our high-risk neonatal follow-up programme.
Why Choose KIMS Cuddles at KIMS Hospitals, Mahadevapura
Therapeutic hypothermia requires a neonatal team experienced in its administration, a servo-controlled cooling system capable of maintaining precise temperature management, and the monitoring infrastructure to manage the physiological complexities of the cooling period safely.
At KIMS Cuddles at KIMS Hospitals, Mahadevapura, all of this is available within a fully equipped NICU, ensuring that eligible babies receive this time-critical treatment without the delay of transfer to a distant facility.
Contact Our Team
If you have a newborn who has suffered from asphyxia at the time of birth and may be a candidate for therapeutic hypothermia, please reach out to KIMS Cuddles, at KIMS Hospitals, Mahadevapura at the earliest. Our neonatal team is available 24 hours a day.
