Treatment for HIE
HIE is managed using a treatment called therapeutic hypothermia, where the baby’s brain or body is cooled down below normal temperatures to slow the cascade effect that causes widespread damage. This allows the baby’s brain to recover and reduces the level of disability they may have as they grow. According to current guidelines, the treatment must be given within six hours of birth, although there is some evidence to suggest it may be beneficial when given up to 24 hours.
Therapeutic hypothermia lasts for around 72 hours, allowing the baby’s metabolic rate to slow. This prevents further damage, known as reperfusion injury, which occurs when normal oxygenation and blood flow are restored too quickly to the brain’s cells. While it may seem counterintuitive that restoring flow quickly could cause further injury, the brain’s cells react differently to rapid oxygenation after being oxygen-deprived. After oxygen deprivation injury, rapid oxygenation can cause more inflammation and the release of certain harmful compounds. Hypothermia treatment works to stabilize the brain’s cells and prevent or limit damaging inflammation.
In addition to therapeutic hypothermia, medical staff should provide supportive care, which can mean helping the baby breathe, controlling and preventing seizures and low blood sugar, minimizing brain swelling, and more. In the long term, babies with brain damage from HIE may benefit from a wide variety of treatments and therapies. Although these are not curative, they can minimize symptoms and maximize function.