Birth Asphyxia

High-frequency ventilation uses a breathing machine that sends small, quick puffs of air into your baby’s lungs. It is more gentle than a regular breathing machine, which sometimes uses high pressure that can damage fragile newborn lungs.

Inhaled nitric oxide is used if your baby has respiratory failure or high blood pressure in the lungs (pulmonary hypertension). Your baby will get nitric oxide through a breathing tube into their airway. This helps open (dilate) the blood vessels in their lungs so the vessels can carry oxygen-rich blood around the body.

Research shows that cooling a baby’s internal body temperature to 33.5 degrees C (about 91 degrees F) for 72 hours can help protect their brain from damage during the second stage of asphyxia. This stage (reperfusion) is when normal blood flow and oxygen are restored to the brain. This treatment works best to reduce brain damage if it is started within 6 hours after birth. This treatment is only used if babies are at least 35 weeks’ gestation (not more than 5 weeks early).

Extracorporeal life support uses a heart-lung pump to provide temporary life support when a baby’s heart or lungs are not working well or need time to heal. “Extracorporeal” means outside the body. Oxygen-poor blood is drawn into a machine that removes carbon dioxide, adds oxygen and then returns the oxygen-rich blood to the baby’s body. We will give your baby sedation while on ECLS. A nurse and an ECLS specialist will closely monitor your baby. The ECLS machine used to be called extracorporeal membrane oxygenation (ECMO).

Babies born too soon (premature) or those who did not get enough oxygen during birth may have permanent injury. This may affect their brain, heart, lungs, kidneys, bowels or other organs.

Babies with asphyxia may develop: 

• Cerebral palsy
• Developmental delays
• Attention deficit hyperactivity disorder (ADHD)
• Hearing problems
• Eyesight problems

After your child receives any urgent or emergency treatment they need, the team at Seattle Children’s plans and provides ongoing care so your child has the best possible outcome. We evaluate all your child’s health needs and work with you to create a care plan that fits your child and family. Catching problems early and getting a referral to specialists may improve outcomes for your child.

Our 32-bed Neonatal Intensive Care Unit (NICU) is the first in the state to be designated level IV. That’s the highest level possible.

We are the only hospital in the Pacific Northwest that provides 24/7 access to all the pediatric medical and surgical specialists your child may need. We stay in close communication with you – and with each other – to plan and provide the best treatment for your child.

We provide the most advanced treatments and services in the region. Some are offered nowhere else in the Northwest. We can monitor and treat babies even when 1 or more body organs have failed.

• Body cooling (hypothermia) to reduce the risk of brain injury in babies with asphyxia.
• Extracorporeal life support (ECLS) that does the work of your baby’s heart or lungs if they are not working well and need time to heal. “Extracorporeal” means outside the body. It is also called ECMO. Our life support team has some of the nation’s best outcomes.
• State-of-the-art breathing support. As needed, we treat your newborn with breathing machines (ventilators) or inhaled nitric oxide (iNO) to open the blood vessels in the lungs.
• Neuro NICU with cutting-edge technology to keep a careful watch on your baby. Near-infrared spectroscopy (NIRS)  measures blood flow in their brain. Video electroencephalography (EEG) helps us monitor brain activity. We use noninvasive MRI (magnetic resonance imaging) to make pictures of your baby’s brain without radiation.
• The largest team of anesthesiologists who specialize in treating only babies and children. Managing your baby’s pain is critical to their healing.
• Continuous dialysis to filter their blood if your baby has kidney failure.
• Mobile life support, including ECLS if needed, to bring babies to Seattle Children’s from anywhere in Washington, Alaska, Montana, Idaho, Hawaii or Oregon. We also can use body cooling during transport.

Our neonatologists are internationally known for their work to protect and heal the brains of babies who did not get enough oxygen at childbirth. We are committed to improving treatments for babies with asphyxia so they have the best possible chance at a healthy life.

Babies in our care can take part in research studies of promising new treatments. These are called clinical trials.

Dr. Sandra “Sunny” Juul co-leads a multicenter national study that uses high doses of the hormone erythropoietin (Epo) combined with body cooling to treat babies with asphyxia. Researchers will test the babies’ thinking and movement at age 2. The goal is to save lives and improve outcomes. The multicenter study is called HEAL (High-dose Erythropoietin for Asphyxia and Encephalopathy). This work builds on earlier research by Dr. Juul and Dr. Dennis Mayock.

Our physician-scientists also:

• Study and test innovative mechanical heart devices. Our goal is to develop safer, more effective devices for children with breathing problems or very weak hearts.
• Look for the best ways to reduce stress in the NICU and relieve pain. They also study the long-term effects of stress and pain on the developing brain.

Learn more about Seattle Children’s research to improve newborn care.

• At Seattle Children’s, your family has a full team behind you. We offer a comforting environment for you and your family.
• We work with you to make decisions and treatment plans for your baby. We invite you to share your insights, questions and concerns during daily meetings of your baby’s healthcare team. The meetings are called “rounds.” Consultations are available to help you sort through confusing or difficult medical issues.
• We work with many children and families from around the Northwest and beyond. We can help with financial counseling, housing, transportation, interpreter services and spiritual care. Our goal is to get you and your baby home – or back to a hospital close to home – as soon as possible.