When newborns suffering from a form of asphyxia at birth have better access to head cooling devices, fewer will face a lifetime of debilitating and costly health complications, according to researchers at Beth Israel Deaconess Medical Center (BIDMC).
The findings, which appear today in the January 2008 issue of Pediatrics, demonstrate through a computer-based modeling technique, that better availability and placement of “CoolCaps” within a regional healthcare system could lead to a 23 percent reduction in the number of newborns likely to develop permanent damage from hypoxic-ischemic encephalopathy (HIE), a form of asphyxia that damages the central nervous system. In Massachusetts, this would produce estimated annual savings of $4.4 million.
“Our analyses confirm that making more cooling caps more available in hospitals can save lives and achieve significant reductions in severe neurodevelopment impairment in babies,” said study co-author James Gray, MD, MS, Department of Neonatology at BIDMC, and the Division of Newborn Medicine at Harvard Medical School. “Importantly, these improvements can be achieved while lowering the costs of care for this group of critically ill infants."
Of the more than four million newborns treated in neonatal intensive care units (NICUs) each year, one in 1,000 suffer from HIE. This condition is caused by a lack of oxygen and blood flow to the brain and can lead to cerebral palsy, mental retardation, blindness or deafness. By using a selective head cooling (SHC) device within a few hours of birth, newborns' body temperature can be decreased by three to four degrees Celsius, thereby limiting or even eliminating damage to the newborn's brain.
The research team, led by Gray and John Zupancic, MD, ScD, Department of Neonatology at BIDMC and Division of Newborn Medicine, Harvard Medical School, used a computer-based industrial modeling technique known as discrete event simulation to examine potential health benefits of making the cooling devices more widely available.