Doctors test if cooling protects newborns from brain damage

Cooling an infant's body may help to prevent brain damage from lack of oxygen during birth, an experiment suggests.

"Widespread application of brain cooling ... would be premature," Dr. Lu-Ann Papile, a neonatologist at the University of New Mexico Health Sciences Center, wrote in an editorial accompanying the study in Thursday's issue of The New England Journal of Medicine.

Most newborn intensive care units lack the equipment and experienced personnel to put the study's results into practice, agreed study author Dr. Rose Higgins of the National Institute of Child Health and Human Development.

The investigators speculated lowering brain and body temperature slows down the injury reactions from oxygen deprivation during birth, since cooling reduces the brain's need for oxygen.

The approach is already used to help adult cardiac patients, but a small study on newborns found no benefit.

Dr. Seetha Shankaran of the Division of Neonatal-Perinatal Medicine at Detroit's Wayne State University School of Medicine and colleagues randomly assigned 208 sick infants with suspected brain injury to receive regular care or the cooling treatment.

Infants in the treatment group were placed on a blanket containing chilled water to cool them to 33.5 C for three days, and were then slowly warmed.

When the infants were examined at 18 and 22 months of age, 44 per cent of those in the cooling group showed a moderate or severe disability or had died, compared to 62 per cent for those who received normal care.

There were no major side-effects of the treatment, although the skin that came into contact with the blanket temporarily hardened and dried, Shankaran said.

The study looked at full-term infants, and it is not known if cooling could help premature infants.

Researchers plan to follow the infants until age six or seven to compare incidence of health problems or learning difficulties.