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Xenon and Cooling Therapy in Babies at High Risk of Brain Injury Following Poor Condition at Birth (CoolXenon2)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
University of Bristol
Information provided by (Responsible Party):
University Hospitals Bristol NHS Foundation Trust
ClinicalTrials.gov Identifier:
NCT01545271
First received: February 29, 2012
Last updated: October 30, 2014
Last verified: October 2014

February 29, 2012
October 30, 2014
May 2012
October 2013   (final data collection date for primary outcome measure)
  • Amplitude Integrated Electroencephalogram (aEEG) grading [ Designated as safety issue: No ]
    Number of hours after birth when aEEG voltage has reached a normal or discontinuous normal pattern
  • Brain MRI [ Time Frame: less than 2 weeks of age ] [ Designated as safety issue: No ]
    Magnetic Resonance Imaging findings at less than 2 weeks of age
  • Amplitude Integrated Electroencephalogram (aEEG) grading [ Designated as safety issue: No ]
    Number of hours after birth when aEEG voltage has reached a normal or discontinous normal pattern
  • Brain MRI [ Time Frame: less than 2 weeks of age ] [ Designated as safety issue: No ]
    Magnetic Resonance Imaging findings at less than 2 weeks of age
Complete list of historical versions of study NCT01545271 on ClinicalTrials.gov Archive Site
Not Provided
Not Provided
Not Provided
Not Provided
 
Xenon and Cooling Therapy in Babies at High Risk of Brain Injury Following Poor Condition at Birth
Xenon and Cooling Therapy in Babies at High Risk of Brain Injury Following Poor Condition at Birth: A Randomised Pilot Study

This study examines the effect of inhaled xenon gas in the treatment of newborn infants with hypoxic-ischemic encephalopathy (HIE) in combination with cooling, which is the standard treatment for this condition. The hypothesis is that the xenon + cooling combination will produce better neuroprotection than the standard treatment of cooling alone.

Not Provided
Interventional
Phase 1
Phase 2
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Hypoxic Ischaemic Encephalopathy
  • Drug: xenon gas
    Inhalation via endotracheal tube of 50% xenon for 18 hours
  • Device: Whole body cooling
    Cooling of baby to reduce rectal temperature to 33.5 degree Centigrade(standard treatment)
  • Experimental: 72h cooling + 18h xenon inhalation
    Babies in poor condition at birth and referred to our neonatal unit for standard therapy of cooling to 33.5 degree C body temperature will be randomised to receive xenon gas at 50% concentration for 18 hours
    Interventions:
    • Drug: xenon gas
    • Device: Whole body cooling
  • Active Comparator: Standard 72 h whole body cooling therapy
    Whole body cooling therapy to rectal temperature of 33.5 degree Centigrade (standard therapy)
    Intervention: Device: Whole body cooling

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
32
October 2015
October 2013   (final data collection date for primary outcome measure)

Infants will be eligible for for the trial if the St Michael's hospital standard inclusion criteria for cooling and additional inclusion criteria for xenon administration are met.

St Michael's hospital standard inclusion criteria for standard hypothermia treatment of 72 hrs:

A: Neonates born at greater than 36 weeks gestation (estimated or clinical assessment) with at least ONE of the following:

  1. Apgar score of ≤5 at ten minutes after birth
  2. Continued need for resuscitation, including tracheal or mask ventilation, at ten minutes after birth
  3. Acidosis, defined as either umbilical cord pH or any arterial, venous or capillary pH within 60 minutes of birth less < 7.00
  4. Base deficit ≥16 mmol/L in umbilical cord blood sample or any blood sample within 60 minutes of birth (arterial or venous blood).

If the infant meets criterion A then assess for neurological abnormality using criterion B and C (by trained personnel):

B: Moderate or Severe encephalopathy as evidenced by any of the following:

  1. Altered state of consciousness (reduced or absent responses or pathological irritability and hyper responsive and at least ONE or more of the following:
  2. Hypotonia
  3. Abnormal reflexes including oculomotor or pupillary abnormalities
  4. Absent or weak suck
  5. Clinical seizures, as recorded by trained personnel

And

C: At least 30 minutes duration of amplitude-integrated electroencephalography (aEEG) recording that shows abnormal background aEEG activity. The decision to cool is based on the worst 30 min section of the aEEG, not the best [35] or seizures (clinical or electrical) thus meeting ONE of the following:

  1. Normal background with some (> 5 min) electrical seizure activity
  2. Moderately abnormal activity (upper margin of trace >10μV and lower margin <5μV)
  3. Suppressed activity (upper margin of trace <10μV and lower margin of trace <5μV)
  4. Definite seizure activity

Additional inclusion criteria for xenon:

Before being considered for additional inhaled xenon therapy via the breathing gas mixture, the infant would need to meet further additional entry criteria (all must be met):

  1. Intubated, ventilated, sedated, being cooled
  2. ≤ 5 hours old
  3. Any seizures under control
  4. Weight > 2nd centile for gestational age
  5. Stable cardiovascular parameters; Mean arterial pressure >40mmHg.
  6. Oxygen requirement via mechanical ventilator ≤ 40%.
  7. Positive End Expiratory Pressure (PEEP) requirement ≤ 6cm H2O
  8. Arterial pCO2 within acceptable range (<7kPa)
  9. Absence of major congenital abnormalities, imperforate anus and in particular any bowel obstruction, congenital abnormalities suggestive of chromosomal anomaly or other syndromes that include brain dysgenesis. Congenital syndromes affecting the brain should be excluded when diagnosed.

Exclusion criteria for cooling in the CoolXenon2 study

  1. Infants expected to be greater than 3 hours of age at the time of starting cooling treatment.
  2. Futility. Where prognosis is considered to be hopeless e.g. no cardiac output for 20 minutes.
Both
Not Provided
No
Contact information is only displayed when the study is recruiting subjects
United Kingdom
 
NCT01545271
CH/2011/3799, 2011-005397-34, 12/SW/0010
Yes
University Hospitals Bristol NHS Foundation Trust
University Hospitals Bristol NHS Foundation Trust
University of Bristol
Principal Investigator: Marianne Thoresen, Professor University of Bristol
University Hospitals Bristol NHS Foundation Trust
October 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP