‘Cool cap’ eases brain damage in oxygen-deprived newborns

A device that looks like a clear plastic cap with water channels going through it is being used exclusively in the Delaware Valley by neonatologists at Thomas Jefferson University Hospital, Philadelphia, to help reduce brain damage in infants.

Known as the CoolCap, the device must be started within six hours of birth and stays on for 72 hours. Babies born at hospitals other than Jefferson University Hospital can be transferred to Jefferson if the problem is recognized immediately at birth.

“Our experience at Jefferson, along with the results of a two-year international clinical trial, shows that the device can lessen the risk of brain injury in newborns who experienced oxygen deprivation or decreased blood flow to the brain at birth,” says Susan Adeniyi-Jones, M.D., professor of Pediatrics at Jefferson Medical College of Thomas Jefferson University.

The study was published in The Lancet, January 28, 2005, and discusses the research undertaken in hospitals in North America, New Zealand and Europe. Twenty- five sites, including Thomas Jefferson University Hospital — the only hospital in Philadelphia to do so — participated in the study. Olympic Medical, of Seattle, makes the CoolCap.

This type of brain damage primarily affects full-term babies. According to Dr. Adeniyi-Jones, one to two percent of all newborns suffer brain injury during labor or delivery. “Until now, there was no treatment to reverse the long-term neurological defects that resulted from the oxygen or blood flow deprivation.

The conventional wisdom is that when a baby is born he or she must be kept warm and is immediately put in a warmer. That is the advantage of this cooling cap over previous devices — it works only on the brain and cools it,” Dr. Adeniyi-Jones says.

“The clear cap with the water channels that are filled with ice-cold water is covered by two layers of fitted caps to prevent the remainder of the baby’s body from being cooled. Further, the baby is kept in a radiant warmer to ensure that the body is kept warm.”

Oftentimes babies who are born with brain insult — interruption of blood flow or oxygen to the brain during labor or delivery — die. Those who don’t are likely to suffer from such disabilities as cerebral palsy or epilepsy, or are learning disabled. It is hoped that this new protocol will reduce the chances of disability in this fragile population.

The Neonatal Intensive Care Unit (NICU) at Thomas Jefferson University Hospital is one of the largest neonatal program in the area with the capability of caring for 40 babies in its intensive care and transitional units. Each year, more than 800 very sick babies are brought to the unit from various hospitals in southeastern Pennsylvania and the tri-state area who are in need of a higher level of critical care.

From Thomas Jefferson University Hospital

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