08:58pm Tuesday 15 October 2019

Switch to cooling blanket spurs new infant brain research

Pediatric neurologists and neonatologists in Vanderbilt’s Neonatal Intensive Care Unit (NICU) are conducting research that may better define what happens in the brains of newborns who have suffered from oxygen deprivation, and what brain cooling therapy can achieve.

Now a switch has been made to a cooling blanket instead of a cap. The blanket is as effective in its brain-protecting capacity, but it offers researchers an opportunity to better assess what is happening in the brain as it is cooled.

Use of a “cooling cap” within six hours is now the standard of care when an otherwise healthy, full-term infant experiences a serious lack of oxygen, called anoxic brain injury. Above, watch the story about baby Maddox Baker, whose parents call him a miracle, and whose best hope of survival after a traumatic birth, was the cooling cap at Vanderbilt’s NICU. The therapy uses cool water to bring the temperature of the brain down about five degrees. Vanderbilt took part in the initial studies of the cooling cap, which was found to reduce serious long-term brain damage and death by about one-third

Pediatric Neurology chief resident, Siddharth Jain, M.D., said by using a cooling blanket, the scalp is free for him to apply a full, nine-lead electro encephalogram (EEG) monitor along with a newer device called a near-infrared spectroscopy (NIRS) monitor to find out what is going on beneath a baby’s scalp.

Jain is working with Barbara Engelhardt, M.D., associate professor of Neonatology, to closely examine what is happening in the first 72 hours after an anoxic injury — the critical window of opportunity in which the cooling seems to have its maximum brain-preserving effect.

The first goal is to use EEG and NIRS to more quickly and accurately predict the severity of the anoxic injury. A second goal is to use the monitors to test new therapies. The hope is the monitors could more quickly assess the effectiveness of therapies is controlling seizures, or better balancing nutrient consumption after injury in the hope of further reducing the risk of permanent brain damage.

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