Department of Pediatrics, Division of Neonatal-Perinatal Medicine, C.S. Mott Children’s Hospital, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Department of Pediatrics, Division of Neonatology, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA
Address for correspondence: Steven M. Donn, M.D., F.A.A.P., 8-621C.S. Mott Children’s Hospital, 1540 E. Hospital Drive, Ann Arbor, MI 48109-4254, USA. Tel.: +1 734 763 4109; Fax: +1 734 763 7728; E-mail: [email protected].
Abstract: Hypoxic-ischemic encephalopathy (HIE) continues to be a significant source of long term neurological sequelae in infants born at or near term. In the past decade, selective head or whole body cooling has shown promising benefit in ameliorating some of the brain injury from intrapartum asphyxial insults and has become standard care in most developed countries. A decision to offer neuroprotective hypothermia (NPH) may engender subsequent litigation because it presupposes an acute intrapartum injury. Conversely, failing to offer cooling may be interpreted as a violation in the standard of care. In this paper, we review the clinical aspects of NPH and the medico-legal scenarios often seen after acute birth injury.