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Discussion

HIE and the CoolCap System

Hi all! I was curious as to how many of your units use the CoolCap system for HIE? I took care of my first patient today who is at the 24-48 hour point of cooling. What have your experiences been with the CoolCap?

From what I hear from past experiences in our unit (this is our unit's 3rd CoolCap kid) it is an awesome system that gives these babies a chance to decrease further HIE blows. It's ALOT of work, charting, maintaining temp, not to mention whatever else the kid has going on: my pt. is in PPHN on N.O. (and AC/PC obviously) and in DIC in addition to all of the other issues secondary to the HIE - CFM shows constant seizure activity, titrating DOPamine, DOBUtamine, Insulin, drawing all the labs that are standing orders for babes on the cooling system and on N.O. and in DIC - this poor babe is going to be anemic tomorrow thanks to us :( But from what I have seen with the other 2 kiddos it gives these babies a chance that wasn't available previously.

Thanks in advance :)

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We were part of the FDA study, and our results basically showed it worked best in kids who were probably not that bad off to begin with. Which seems kind of obvious to me. But I'm going to the official unit training tomorrow, because now that it's approved we're going to start doing it again, so I'll see if I get any better info then.

can you post a site regarding what this is and/or looks like?

we use systemic cooling (via blanketrol) to prevent further cell death post hie and have had good outcomes. there is a load of evidence that suggests it is beneficial including a cochrane review in the last few years. our unit also took part in the ice trial (www.cs.nsw.gov.au/rpa/neonatal/html/docs/hypothermia.rtf )

i do not know what the benefits are of cooling cap vs systemic cooling. i do not that it is not considered acceptable to cool infants core temp by reducing the ventilator air temp as this causes lung damage.

our most recently cooled baby has just turned around 1 year old and has been meeting all her milestones after grade 3 ivh and given a prognosis of severe cp.

The cooling has made a Major difference in outcomes! There is an article in the New England Journal of Medicine by Seetha Shankaran that details the difference in outcomes.

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