Simply placing a cold cap on a baby's head may be enough to protect it from brain damage and possible death. So report researchers today in the first study to demonstrate an effective treatment for oxygen deprivation in newborns.
Oxygen deprivation at birth is a serious matter. It can cause learning disabilities, cerebral palsy, or death in 0.1 to 0.2% of otherwise healthy full-term babies. To date, there has been no treatment available for this rare event, which results from abnormalities and complications during delivery.
Pediatric and perinatal biologist Peter Gluckman, now at the Liggins Institute in Auckland, New Zealand, and colleagues first began investigating the problem 20 years ago. The team discovered that oxygen-deprived brain cells don't die immediately. The brain produces compounds that stop cell death, but it takes 2-3 days for the cells to accumulate sufficient levels. So the researchers hit on the idea of cooling the brain for 2-3 days to slow down the process of cell death and buy the brain time to heal itself. After testing the idea on sheep fetuses, the researchers developed a cooling cap for newborn babies. Cooled water is pumped through the cap, which lowers the baby's body temperature by 2-3 degrees Celsius for 3 days following birth.
Gluckman recently teamed up with John Wyatt, a neonatal pediatrician at University College London, in the United Kingdom, and colleagues to run a clinical trial of the cooling cap. In a sample of 234 full-term newborn babies, the researchers found that the cooling cap reduced the incidence of severe disability at 18 months by nearly 60% in moderately oxygen-deprived babies compared with controls given standard clinical care. However, the cap could not help severely affected babies, the researchers report online 28 January in The Lancet.
Gluckman believes that with further refinements of the treatment regime, the "group of absolutely untreatable babies will shrink," and the procedure could also be applied to premature babies suffering from oxygen deprivation. Cooling is also being investigated as a treatment for heart attack, stroke, and head trauma patients, he says.