Birth asphyxia is a major cause of death and of acquired brain damage in newborn infants. By demonstrating the success of a new cooling treatment, researchers at the University of Oxford have helped bring the new treatment into regular clinical practice. This has reduced newborn deaths and the severity of disability, which has a profound effect upon the quality of life for the patients and their families, as well as relieving the long-term pressure on NHS resources.
Asphyxia is caused by a lack of oxygen in the brain and severe birth asphyxia occurs in about 1/1000 live births, causing death or a severe neurological impairments like cerebral palsy, developmental delay or learning and behavioural problems. Few infants survive the condition without handicap, often a major burden for the baby and its family. In collaboration with the Hammersmith Hospital, Imperial College London, researchers at the University of Oxford have shown the success of a cooling treatment and promoted it into regular clinical practice.
The Total Body Hypothermia for Neonatal Encephalopathy Study (TOBY), led by the University of Oxford, has recently proven that cooling a suffering baby to 33oC for a number of days after birth is the only medical intervention which reduces brain damage and improves an infant’s chances of normal survival after birth asphyxia.
As a result of the findings from the TOBY Study, cooling treatment has been increasingly offered across the UK. The National Institute for Health and Clinical Excellence (NICE) published new guidance in May 2010, based on the TOBY Study and others, to support the use of cooling as a routine treatment option for babies born with birth asphyxia. Clinicians are encouraged to enter the details of each cooled baby into the UK TOBY Cooling Register which will contribute to the long-term evidence of the safety and efficacy of cooling. In July 2010, the British Association of Perinatal Medicine (BAPM) recommended that ‘all infants who are cooled should be entered on to the TOBY Registry’.
By May 2011, 66 cooling centres were contributing to the Register and further UK hospitals are preparing to offer treatment. The UK TOBY Cooling Register is a valuable asset capable of monitoring adverse events as well as the efficacy and safety of treatment.
By helping to bring cooling into common clinical practice for birth asphyxia, the researchers have significantly improved the chances of babies affected by this fatal illness to survive without any lifelong effects.
Funded by: Medical Research Council, Neonatal Taskforce.