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UC Irvine transport service is region's first to offer whole body cooling for critically ill infants

Timely cooling may prevent brain damage in oxygen-deprived newborns

September 30, 2013

Timely transport of a critically ill newborn from a community hospital to a regional neonatal intensive care unit may mean the difference between life and death or a life free of physical or mental impairment. Now experts at UC Irvine Medical Center, home to Orange County’s only high-risk regional perinatal-neonatal center, are hitting the road with a cooling technology that may prevent or minimize brain damage to infants who are oxygen-deprived at birth.

“We believe applying whole body cooling to newborns en route to UC Irvine Medical Center will give infants with the most critical brain injuries a better chance to recover,” said Dr. Cherry Uy, director of the UCI Health Regional Neonatal Intensive Care Unit.

Also called therapeutic hypothermia, whole body cooling uses a specially-designed blanket to lower an infant’s body temperature to 92.3 to 94.1 degrees Fahrenheit. Studies show that such cooling may prevent brain damage in a newborn that experiences hypoxic-ischemic encephalopathy, or loss of oxygen, at birth. Decreased oxygen and/or blood flow to the brain is a leading cause of brain injury in newborns and may lead to cerebral palsy, or cognitive and visual impairments. Two or three of every 1,000 babies will suffer from oxygen deprivation during delivery.

UCI Health has the only maternal-neonatal transport service in Southern California with the ability to start temperature-regulated active cooling upon arrival at a referring hospital. In January, UCI Health and CARE ambulance services will unveil an ambulance specially designed to accommodate a cooling unit. A portable system will be used until then.

“After reviewing studies and our own experience, we determined that whole body cooling would be more effective for our patients than other cooling methods,” said Dr. Uy. “We are happy to work with our partners at hospitals across Los Angeles, Orange and Riverside counties to intervene when a complicated pregnancy or complex delivery places a newborn’s health in jeopardy.”

Since most hospitals don’t have a regional NICU or obstetricians experienced in treating high-risk pregnancies, the UCI Health response team is available 24/7 and includes a physician, nurse or respiratory therapist specially trained in caring for the most vulnerable infants.

Neonatal intensive care specialists supervise the cooling procedure. For best neurologic outcome, cooling must be started shortly after birth. Once contacted about a critically ill newborn or a complex delivery, the UCI Health team works staff at the referral hospital to monitor the infant’s condition until the transport team arrives.

UCI Health has long been a leader in perinatal and neonatal critical care, including:

  • More very low and extremely low-birth weight infants delivered and treated at UC Irvine Medical Center than anywhere else in Orange County.*
  • Among the region’s top sites for multiple births delivery and treatment.*
  • For two consecutive years, extremely low birth weight infants born here experienced zero incidence of severe intraventricular hemorrhage, a form of bleeding in the brain that is a common and dangerous complication of premature birth.
  • Unmatched expertise in high-risk surgical procedures like fetal transfusions and EXIT, or ex utero intrapartum therapy, a procedure used to secure a baby’s airway prior to delivery.

UC Irvine Medical Center has one of Orange County’s highest-level NICUs to care for critically-ill newborns with the most challenging health complications. As a Regional Level III unit, it meets the most rigorous standards set by the state of California. The 45-bed unit houses advanced diagnostic tools and technologies to treat a wide range of conditions, and features a multidisciplinary team that includes highly-trained neonatologists, nurses, respiratory therapists, nutritionists, occupational therapists, physical therapists and social workers.

The multidisciplinary program is Orange County’s only service that combines specialists in high-risk obstetrics with experts in newborn care and has produced some of the nation’s best outcomes for complicated pregnancies.

 * Data from California Perinatal Profiles, California Maternal Quality Care Collaborative.

UCI Health comprises the clinical, medical education and research enterprises of the University of California, Irvine. Patients can access UCI Health at physician offices throughout Orange County and at its main campus, UC Irvine Medical Center in Orange, Calif., a 412-bed acute care hospital that provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation. U.S. News & World Report has listed it among America’s Best Hospitals for 13 consecutive years. UC Irvine Medical Center features Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program, Level I trauma center and Level II pediatric trauma center, and is the primary teaching hospital for UCI Health School of Medicine. UCI Health serves a region of more than 3 million people in Orange County, western Riverside County and southeast Los Angeles County.