'Brain Cooling' Prevents Devastating Consequences for Newborns
February 27th 2011 20:57
Every year in the UK, over 1000 newborn babies die or suffer brain injury as a result of lack of oxygen at birth [1].
Birth asphyxia is a devastating complication in otherwise healthy full-term infants, occurring when the blood flow to the brain is cut off during labour and childbirth. When the brain and vital organs are starved of oxygen, the risk of death or lifelong disability such as cerebral palsy is worryingly high.
Professor Marianne Thoresen at St Michael’s Hospital, Bristol has been pioneering cerebral protection treatments for brain injury in babies since 1998. She was the first to show that cooling babies after a lack of oxygen can protect the newborn brain, reducing and in some cases eliminating brain damage. Cooling techniques can reduce the death rate, risk of seizures and long term disabilities including cerebral palsy.
Talking to a parent of a recently cooled baby on 24th February 2011, Professor Thoresen described how data taken from babies treated at St Michael’s Neonatal Intensive Care unit indicates that the risk of poor outcome after perinatal asphyxia falls from 66% to 40% when cooling techniques are used [2].
Cooling helps to decrease the amount of cerebral swelling around the brain after birth and slows down cell death [3]. The metabolic rate is lowered by the cooling effect so the brain and other organs need less oxygen to function. The procedure which involves lowering the temperature of critically ill newborn babies by 3°C immediately after birth, has now been introduced as standard of care after birth asphyxia incidents under international guidelines and NICE recommendation.
The treatment is given to carefully selected babies [4] who are most at risk of severe long term disability or death due to oxygen deprivation. Cooling is administered for 72 hours followed by gradual re-warming to normal body temperature in intensive care. The effectiveness of this neuroprotective treatment is better when cooling is started immediately after the injury [5], therefore it is extremely important that healthcare staff are aware of essential procedures when asphyxia occurs (Gunn and Thoresen, NeuroRx, 2006).
Professor Thoresen is currently studying an additional treatment which, when combined with cooling, further reduces the risks of long term disability. Xenon, an anaesthetic gas, has been shown to double the protective effect of brain cooling [6].
The ongoing research should steadily lead to further breakthroughs and improved survival prospects for many more newborns. The research has been largely funded by Sparks, the children’s medical research charity and the team are in desperate need of more funds
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