Background on Cooling Blankets

Four out of every thousand babies born in the U.S. suffers brain damage. Traditionally, there was nothing doctors could do to prevent the lifetime of disabilities that could follow besides supportive care. But now, they're using a simple blanket to save brains and change lives. The cooling blanket is a new hypothermia treatment that may prevent or minimize the long-term consequences of brain injury due to hypoxic-ischemic encephalopathy (HIE), or loss of oxygen at birth: cerebral palsy, cognitive and visual impairments.  Perinatal hypoxic-ischemic brain injury is now understood to occur in two phases. The first occurs during the peripartum period when the fetus's brain is exposed to asphyxiation because of inadequate blood flow supplying oxygen to the brain. The second occurs in the hours after birth and is due to secondary energy failure.

Induced hypothermia (the cooling blanket) aims to minimize the damage or prevent infants from experiencing this second phase of brain injury. It involves placing an infant onto a cooling blanket, which quickly reduces the baby’s core temperature down to 33 degrees centigrade. The normal baby’s core temperature is around 36.5 degrees centigrade. That three degree decrease in temperature actually helps any areas of the brain that are potentially injured. The cooling must be initiated within six hours of birth-preferably as soon as possible. The infant is cooled for 72 hours and then gradually warmed. The babies are monitored with amplitude-integrated electroencephalogram (aEEG), serial neurological examinations, and laboratory and imaging studies before, during and after the procedure. Original research studies on the cooling blanket came out in 2005.  There were three large randomized clinical trials that demonstrated that cooling was safe and that it could help babies with brain injury. HIE babies are divided into three categories – mild, moderate, and severe. Cooling primarily helps babies with moderate encephalopathies.  Cooling is a state of the art therapy that is confined mostly to academic medical centers currently.  It is still very experimental and there has been very little research done.

The cooling blanket is a very simple device. It circulates water, and that water is cooled to a certain temperature. It draws heat away from the baby as this water is circulated and cools their temperature down to 33 degrees.  It’s been shown to be a very safe therapy because the temperatures used are in the moderate category of hypothermia, and complications associated with hypothermia aren't present until you are less than 30 degrees centigrade.

I am still trying to find stats on how many hospitals have the cooling blanket and how many babies have been cooled.