How a ‘wine cooler’ vest can save babies from brain damage
BABI E S starved of oxygen at birth may be saved from lifelong disability thanks to a high- tech ‘ wine cooler’ vest wrapped around their tiny body and legs. Similar devices have been used to help adult stroke and cardiacarrest patients after neurologists found that dropping body temperature is ‘neuro-protective’, reducing the number of brain cells that die during such events.
Health chiefs are now recommending it as standard treatment for babies suffering hypoxicischemic encephalopathy ( HIE) – brain injury due to asphyxia prior to or during a traumatic birth.
Last year the NHS Litigation Authority revealed that the compensation bill to the NHS for errors that occurred during birth was at an all- time high of £ 510 million, and experts hope the remarkable success of body-cooling technology may help in reducing this.
The parents of one boy, now nine years old, who benefited from the treatment have spoken of the ‘miraculous’ recovery he made.
In a Sky TV documentary to be aired later this month, Stephanie and Alastair Chambers reveal the battle to save the life of their son Harry, who was born ‘purple and completely unresponsive’. Doctors at Gloucester Royal Hospital had to ‘kick-start’ his heart with adrenaline shots, and he eventually began to breathe after 20 minutes.
HIS chances of survival were slim and his parents were warned that even if he did pull through, he would be l eft profoundly brain- damaged and facing severe disability. ‘His blood was so lacking in oxygen, the consultant described it as acid,’ said Alastair, 36, who runs a building company in Gloucester.
Yet today Harry is a healthy nine-year-old who, despite being deaf, attends a mainstream school and enjoys gymnastics, comput er games and playing with his three brothers and one sister.
Alastair now fundraises for the medical charity Sparks, which sponsored trials into the cooling technology that saved his son. He said: ‘We weren’t expecting Harry to be able to walk or talk and we’re immensely proud of what he achieves every day.’
HIE affects about one in 500 births, and a quarter of these babies develop cerebral palsy, a lifelong disability that impacts muscle control and growth and can also be associated with learning disabilities. In more severe cases, infants suffer seizures and lifethreatening brain swelling.
Whole-body cooling for infants has proved to be remarkably successful in transforming the odds for these babies.
The technique was pioneered by neonatal intensive care specialist Professor Marianne Thoresen at Bristol Royal Infirmary and Universi t y Coll e ge London. Her research suggested that among oxygen-deprived babies who are cooled, the chances of surviving without disability are increased from 28 per cent to 41 per cent.
Mortality was sl ashed f rom 34 per cent to just nine per cent.
Exactly how cooling works to protect babies from brain damage is not known. However, Prof Thoresen said: ‘ The nerve cells in the brain can manage for much l onger without oxygen at l ow temperatures. The body works more slowly and the speed at which cells die is slower.
‘With lack of oxygen, some nerve cells die immediately and you can’t revive them, but lots of them just get sick and what happens in the next few days decides whether or not the cells are going to survive. We found that with cooling, more cells survived than died.’
Although initial trials involved a cap that cooled just the head, trial results of the ‘wine cooler’ jacket had far better results.
THE device is made up of soft-plastic sheets covered in cotton. These are wrapped around the legs and torso and secured with Velcro. The sheets contain numerous hollow channels through which fluid can be pumped in and out.
Prof Thoresen said: ‘ It’s a bit like a high-tech wine cooler – we have complete control over the temperature. It’s very clever.’
A machine keeps the fluid at a constant temperature, regulated automatically via feedback from a rectal thermometer. Normal temperature for a newborn is cooler than an adult – about 36.5C instead of 37C. The jacket reduces body temperature to a constant 33.5C for 72 hours. The body is then warmed using blankets and an overhead heater over the next few days.
Without such intervention, Harry Chambers was not expected to pull through. Alastair said: ‘At one point, the consultant said they would have to turn off Harry’s life-support machine and we’d probably have 30 minutes to say goodbye.
‘But we were then told about a therapeutic hypothermia trial that could help Harry. We had nothing to lose, so agreed. They put him into a hypothermic state and I have no doubt it saved his life.’
Harry’s mother Stephanie, 37, added: ‘We have a photograph of Harry in his cooling jacket in the specialist baby unit. Now we have a happy, healthy little boy.’
The Chambers family tell their story in a new five-part Sky 1 series, Inside The Freemasons, starting tomorrow.