Hypothermia Treatment and the Newborn

Publisher Website
Google Scholar
Abstract
“Sarah Parks … gave still-birth to a baby boy … A young doctor assisting the Parks' regular physician begged for an opportunity to experiment with an idea he had to rouse the lifeless infant. A tub of ice was ordered and the young doctor plunged the baby into it. Out came the screaming little Parks and he was named Gordon after the doctor who prodded him to life.”—Sir John Floyer, 1697 As this quotation shows, the use of cold water to stimulate the onset of respiration in depressed newborn infants has a long history. However, it was James Miller from New Orleans and Bjorn Westin from Stockholm who in the 1950s developed a scientific rationale for the use of hypothermia in “asphyxia neonatorum.” In a series of animal studies they demonstrated that rapid cooling in asphyxia prolonged survival by allowing the establishment of an equilibrium between cerebral oxygen demand and supply (reviewed in reference 1). They followed this in 1958 with a striking clinical study involving 10 severely depressed term infants.2,3 The infants all had Apgar scores of 1 at birth and they had failed to respond to conventional methods of resuscitation available at that time. The apneic infants were immersed in a specially constructed cold water bath with the aim of reducing core temperature rapidly. Cooling was stopped when spontaneous respirations commenced or when the rectal temperature approached 27°C. In 4 infants transfusions of oxygenated blood were also administered. The infants were then dried and allowed to rewarm spontaneously. One of the 10 infants died due to hyaline membrane disease but the remaining 9 survived, despite minimum core …