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Head Cooling May Help Brain Damage in Babies

Special 'Cooling' Caps Provide Slight Improvement for Some Oxygen-Deprived Newborns
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Jan. 27, 2005 -- Cooling the heads of certain babies deprived of oxygen at birth may make death and brain damage slightly less likely.

Oxygen deprivation affects one or two out of every 1,000 babies, say researchers in The Lancet's online edition. The condition can cause death or brain damage. Nothing has been proven to fix the problem.

Professor Peter Gluckman, FRS, of New Zealand's University of Auckland and colleagues tried a new solution. They wanted to see if it helped to cool the heads of oxygen-deprived babies. The idea was based on experiments showing benefits for reducing brain temperature by a few degrees (2 to 5 degrees Celsius).

Results came from 218 babies that didn't get enough oxygen at birth or whose brain-electrical activity indicated a high risk of brain injury. The babies were followed for 18 months.

Half of the babies wore special "cooling" caps for 72 hours, starting six hours after birth. The other 110 babies got standard care, without head cooling.

The caps contained a thermostatically controlled cooling unit, with a pump circulating water through the cap. With the caps on, the babies' rectal temperature was 93 to 95 degrees Fahrenheit. Normal rectal temperature is 97 to 100 degrees Fahrenheit.

Unfortunately, the cooling caps didn't make a dramatic difference.

Many of the babies died or had severe disability within 18 months. That included 66% of infants receiving conventional care and 55% of those that wore the head-cooling caps for three days after birth.

However, babies with less severe electrical brain changes did appear to benefit. Brain damage and risk of death did go down slightly in babies that underwent head cooling.

"The effect was not significant," say the researchers. They also say there's a fine line between the pros and cons of cooling babies' heads.

"There is a potential trade-off between the adverse systemic effects of cooling, which increase greatly below a core temperature of about 34 degrees Celsius [93 degrees Fahrenheit], and the possibility of cerebral benefit," they write.

Still, they say the strategy could possibly help some babies, to some degree. The most severe cases probably wouldn't gain anything from head cooling, say the researchers. They suggest that future trials focus on babies that are most likely to respond.

The cooling cap's maker provided financial grants for the study, and the University of Auckland has applied for a related patent, the study says.

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