Reducing the brain temperature of newborns deprived of oxygen at birth could lower their risk of brain damage.
Oxygen deprivation at birth affects about two babies in 1000 newborns and can cause brain injury. Experiments have suggested that reduction in brain temperature of 25°C applied after oxygen deprivation can help lessen brain damage.
In the CoolCap study Alistair Gunn at the University of Auckland, New Zealand, and colleagues investigated whether 72 hours of selective head cooling, started within 6 hours of birth, improved brain development at 18 months in infants at high risk of brain damage.
The study involved 234 infants who had received an inadequate supply of oxygen to the brain during delivery or whose brain electrical activity indicated a high risk of brain injury. The 108 infants randomly assigned to the head cooling arm of the study were fitted with a cooling cap for 72 hours. The 110 infants assigned to the control arm received conventional care. In total 218 infants were followed up after 18 months.
The investigators found that 55% of group who had head cooling died or were severely disabled and 66% of group who received conventional care died or were severely disabled. The result suggests that head cooling started within 6 hours of birth was of some benefit to infants with moderate to severe brain damage, but the effect was not statistically significant.
Gunn comments: Our study suggests that, except in the most severe cases, selective head cooling soon after birth could be a clinically feasible treatment to reduce disability due to neonatal brain damage. In the future, measurements of brain electrical activity may help us to target treatment to the babies who are most likely to benefit from cooling.
Source: The Lancet, 2005