INFLUENCE OF TEMPERATURE UPON 

 RESISTANCE TO ASPHYXIA^ 



James A. Miller, Jr., Department of Anatomy, 

 Emory University, Georgia 



A, 



.DVANCES in pre- and postnatal care of the mother have so reduced the 

 hazards of childbirth that in many hospitals thousands of babies are born 

 without a maternal death (146j. To the baby, however, his birth day 

 has not only remained the most hazardous day of his life but, by virtue 

 of the great improvements in mortality rates for the other 364 days of 

 the first year, is becoming relatively more dangerous than ever before (120) . 

 It is well recognized that asphyxia of the newborn is the largest single 

 factor in death during the perinatal period. In addition, the role of asphyxia 

 in the genesis of cerebral palsy and many types of mental defects is 

 beginning to be accorded the attention that is deserves (26, and references 

 quoted). Twelve years ago it occurred to the writer that a new approach 

 to the treatment of asphyxia of the newborn might be made through the 

 aegis of hypothermia, based on the very elemental rationale that a 

 reduction of body temperature should prolong asphyxial survival by re- 

 ducing metabolic requirements. If the logic held, it should not only post- 

 pone the time of death, but actually prevent it. In addition, hypothermia 

 should reduce the brain damage which often makes its tragic appearance 

 in individuals in which resuscitative measures are successful. 



THE PROBLEM 



The events which lead a person to undertake a research problem are 

 usually of interest and often are instructive in addition. Perhaps it might 

 be of interest to general physiologists to learn that the concept of utilizing 

 hypothermia for asphyxia in man was a direct result of training in and 

 experience with the invertebrates. The author's experience with hypo- 

 thermia began when as a graduate student it was discovered that reduction 

 of temperature was the safest and most easily controlled method of 

 narcotizing planarians for transplantation operations (115, 116). Thirteen 

 years later the sight of an asphyxiated newborn infant being warmed 

 in a bassinet raised important questions. Why elevate the metabolism and 

 therefore the requirements for oxygen at a time when vital processes are 

 in jeopardy from its lack? Might it not be that this treatment actually 



^ Aided by grants from the National Institutes of Health and Emory University. 



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