Cooling Treatment Helps Oxygen-Deprived Newborns

St. Luke's Hospital Cedar Rapids

Doctors at St. Luke's Hospital used cooling blankets immediately after Deegan Mizaur's birth to keep him alive and to minimize potential disabilities. Deegan was born without a pulse and remained that way for nine minutes following his birth. Prior to his birth - his mother, Gale Ziese arrived at St. Luke's last October for what she thought was going to be a routine delivery after her water broke at home.

"Deegan was born a little over three weeks early," said Ziese. "When I arrived at St. Luke's I mentioned he might be breech. A quick ultrasound indicated he was and I was prepped for a C-section. Suddenly Deegan's heart rate plummeted and I was rushed into the operating room for an emergency C-section."

When Ziese awoke after surgery her fiancé, Kyle Mizaur, was in St. Luke's Newborn Intensive Care Unit (NICU) standing watch over his son following his traumatic birth.

"After Deegan was born not breathing the doctors worked to revive him," said Ziese. "They were successful. The St. Luke's NICU team used a pediatric cooling blanket to lower his body temperature."

This treatment is called systemic hypothermia or total body cooling. The St. Luke's NICU team used a pediatric cooling blanket to lower the Deegan's body temperature to 92.3° Fahrenheit for 72 hours and then slowly rewarmed him to normal temperatures. Cooling the body slows down the basic functioning of the body and may decrease injury to the brain caused by the lack of oxygen (hypoxia) and the lack of blood flow. St. Luke's started offering this treatment because a number of large research studies have now shown that when babies are treated with hypothermia shortly after birth, they have less risk of dying and less brain injury. This means fewer cognitive and motor problems compared to those babies not treated with hypothermia.

"Any time a baby doesn't have a heart rate for a period of several minutes, we are concerned about the potential lack of oxygen in the baby," said Dennis Rosenblum, MD, St. Luke's NICU medical director. "The longer a baby goes without breathing or a heart rate, particularly at around 10 - 15 minutes of age, the more concerned we are about the worst possible prognosis. We worry about transient effects, like damage to the liver, kidneys and heart. But more importantly we are concerned about long-term effects, particularly to the brain, that may not be reversible."

After a baby is revived, there's a six-hour window of opportunity to induce hypothermia before there is an increased rate of brain cell death.

"We just started using this cooling treatment within the last couple of years at St. Luke's when the medical literature clearly indicated it was beneficial," said Dr. Rosenblum. "The advantage for us and for the babies is that we can start cooling right away without having to transfer babies to another hospital where they have to wait to be cooled."

For babies who have had prolonged hypoxia, this treatment decreases death rates or rates of moderate to severe neurologic impairment to about 30 - 50 percent, compared to a 50 - 80 percent rate of death or neurologic impairment for those who don't receive this therapy. St. Luke's is the only hospital in the Cedar Rapids area that uses total body cooling for newborns.

"As a team, we are always trying to stay on the cutting edge of best practices and providing the highest quality outcomes for our patients and their families," Rosenblum said.

"We are grateful we were at St. Luke's NICU where they have this treatment available," said Ziese. "Deegan's care was pretty amazing. I was so impressed with the doctors and nurses in St. Luke's NICU."

Deegan spent 26 days in St. Luke's NICU. He went home using oxygen but today his mom reports that he is a healthy eight-month old.

"Deegan is doing amazing," said Ziese. "He is crawling and trying to stand up. He's doing everything a baby his age should be doing. The only thing they predict is having vision problems. He's constantly on the go, a very happy baby."

St. Luke's NICU is the area's only Level II Regional Neonatology Center, caring for 300 to 400 babies each year. Learn more at www.unitypoint.org/cedarrapids/services-newborn-intensive-care.aspx.