'Cooled' baby Ella shows no signs of brain damage
- 3 March 2011
- From the section Health
A baby girl born starved of oxygen whose body was cooled for three days to reduce brain damage, has made a complete recovery.
Doctors at Addenbrooke's Hospital in Cambridge wrapped baby Ella in a special blanket filled with fluid which cooled her whole body down from the normal 37C to 33.5C.
Inducing hypothermia is a procedure used on oxygen-loss babies.
Ella is now a healthy nine-month-old with no sign of brain abnormalities.
She was born at Peterborough Maternity Unit after a traumatic labour in which Rachel, Ella's mother, is thought to have suffered a ruptured placenta.
This would have restricted the baby's oxygen and blood supply, causing Ella to suffer from HIE (hypoxic ischemic encephalopathy), which can lead to severe brain damage.
In Ella's case, no heartbeat could be detected at birth, so doctors resuscitated her and gave her life support for more than 20 minutes to help her to breathe.
Then they started the cooling process to reduce the swelling around her brain, before the decision was made to transfer her to Addenbrooke's Hospital 30 miles away to continue her cooling treatment.
There she was nursed in a special wrap that cooled her whole body to four degrees below normal. The wrap is filled with fluid that can be cooled or warmed as necessary. Probes are used to monitor core and surface temperatures to ensure the target temperature is maintained.
Research has shown that cooling can limit the degree of brain injury and this 'hypothermia' treatment is now widely used to help the brain repair itself after trauma.
Ella's consultant Dr Topun Austin, a neonatologist at Addenbrooke's Hospital in Cambridge, said: "We had always thought that there is not much you can do after brain damage, but a recent study showed that brain cells took 24 to 48 hours to die so there is a window during which brain damage can be stopped.
"Lack of oxygen is a trigger but it doesn't not happen immediately. The damage can be prevented."
Brain injuries from HIE and perinatal asphyxia can be so severe that some babies do not survive. Of the babies who do survive, some may go on to develop anything from a mild to a severe disability.
"These are very sick babies. The key is to identify and treat them as early as possible - and start cooling them as soon as possible," Dr Austin said.
"It's a relatively simple thing to do and should be done routinely."
The cooling treatment is thought to work particularly well on babies who experience an acute, sudden lack of oxygen, like Ella.
Professor Donald Peebles, spokesperson for the Royal College of Obstetricians and Gynaecologists and a consultant obstetrician at University College London Hospital, said inducing hypothermia in oxygen-starved babies was fairly routine.
"It's not a perfect treatment, but as long as you get in there quickly research shows that one in eight given this cooling treatment will not have any brain damage."
Experts say, however, that it is not possible to know how effective the treatment has been until the babies are much older.
'Cooled' babies will be monitored closely by paediatricians for the first few years of life.