Birth asphyxia is a serious complication in otherwise healthy full-term infants, occurring when the blood flow to the brain is restricted 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 neurological protection treatments for brain injury in babies since 1998. She was one of the first to show that cooling babies who have suffered lack of oxygen around the time of birth can protect the newborn brain, reducing and in some cases eliminating brain damage. Cooling techniques can reduce the death rate, as well as the risk of seizures and long-term disabilities such as cerebral palsy.
Talking to a parent of a recently cooled baby in 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] [24th February 2011]..
Cooling therapy helps to reduce the amount of swelling around the brain after birth and slows down cell death [3]. The metabolic rate is lowered by cooling so the brain and other organs need less energy to function. The procedure which involves gradually lowering the temperature of critically ill newborn babies by 3°C immediately after birth, has now been introduced as 'standard of care' under international guidelines and NICE (National Institute for Health and Clinical Excellence) recommendation when birth asphyxia occurs.
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 that, when combined with cooling, further reduces the risks of disability. Xenon, an anaesthetic gas, has been shown to double the protective effect of brain cooling [6]. Read more about xenon treatment here.
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 need of more funding to continue the work. Click here to find out how you can help.
References:
1 - Jeremy Laurance, "Cooling Cure Averts Infant Brain Damage" 1st October 2009, The Independent ,Accessed 24th February 2011
2 - Marianne Thoresen MD, PhD. Personal Interview with Josie Budd. 24 February 2011.
3 - Horizon. (2010). ‘Back From the Dead’, BBC2, 29 Oct 2010.
4 - Thoresen M. "Hypothermia as a neuroprotective intervention for neonatal encephalopathy" from Bristol Protocol for Theraputic Hypothermia 2010
5 - Thoresen M. "Tips and Cautions with Cooling", from Bristol Protocol for Theraputic Hypothermia 2010
6 - Chakkarapani E and Thoresen M. "Use of Hypothermia in the Asphyxiated Infant", perinatology (Perinatology 2010; 3:20-29)
Josie Budd - Hi, I am a writer, personal growth blogger, photographer, meditator and mother based in Glastonbury, UK. As a writer and science graduate, ...
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