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Neuroprotective Effects of Hypothermia Combined With Inhaled Xenon Following Perinatal Asphyxia (TOBYXe)

This study has been completed.
University College London Hospitals
Guy's and St Thomas' NHS Foundation Trust
Information provided by (Responsible Party):
Imperial College London Identifier:
First received: July 7, 2009
Last updated: October 27, 2014
Last verified: April 2012
This is a randomised controlled trial in newborn infants with perinatal asphyxial encephalopathy assessing whether a combination of hypothermia and inhaled xenon preserve cerebral metabolism and structure.

Condition Intervention Phase
Hypoxic Ischaemic Encephalopathy
Other: Xenon gas
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Neuroprotective Effects of Hypothermia Combined With Inhaled Xenon Following Perinatal Asphyxia

Resource links provided by NLM:

Further study details as provided by Imperial College London:

Primary Outcome Measures:
  • The primary outcome will be: reduction in Lac/NAA ratio on magnetic resonance spectroscopy or preserved fractional anisotropy measured on diffusion weighted magnetic resonance imaging [ Time Frame: 10 days ]

Secondary Outcome Measures:
  • Clinical outcomes at hospital discharge [ Time Frame: At discharge from hospital ]

Enrollment: 92
Study Start Date: February 2012
Study Completion Date: September 2014
Primary Completion Date: September 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Combination of hypothermia and xenon
Combination of hypothermia and inhaled xenon
Other: Xenon gas
30% Xenon gas inhaled for 24 hours
Other Name: LENOXe
No Intervention: Hypothermia and standard intensive care
Hypothermia and standard intensive care

Detailed Description:
The study hypothesis is that: Following perinatal asphyxia treatment with a combination of hypothermia and inhaled xenon preserves cerebral metabolism and structure. Following informed parental consent, infants that continue to require endotracheal tube ventilation following resuscitation will be randomised to treatment with hypothermia only or hypothermia and xenon. All infants in both groups will be treated with hypothermia for 72 hours started within 6 hours of delivery and infants allocated to hypothermia and xenon will also receive 30% xenon (balanced with oxygen and air) for 24 hours through a purpose designed delivery system. Structured neurological examination will be done daily during the 1st week after birth and at discharge. MRS and MRI will be performed once between 4-10 days of age. MRS/MRI data analysis will be by investigators blinded to the allocated intervention.

Ages Eligible for Study:   up to 12 Hours   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Infants will be eligible for enrolment into the trial if each of the following criteria is fulfilled:

  • Infants 36 to 43 weeks gestation with at least one of the following:

    • Apgar score of <5 at 10 minutes after birth;
    • Continued need for resuscitation, including endotracheal or mask ventilation, at 10 minutes after birth;
    • Acidosis defined as pH <7.00 and/or base deficit >15 mmol/L in umbilical cord blood sample or any blood sample within 60 minutes of birth (arterial or venous blood).
  • Moderate to severe encephalopathy consisting of altered state of consciousness (reduced or absent response to stimulation) and hypotonia, and abnormal primitive reflexes (weak or absent suck or Moro response). Clinical severity of HIE will be assessed by Thompson encephalopathy score, and modified Sarnat score.
  • At least 30 minutes duration of amplitude integrated EEG (aEEG) recording that shows moderately abnormal or suppressed background aEEG activity or seizures

Exclusion Criteria:

  • If treatment with hypothermia is delayed beyond 6 hours, or infants are expected to be >12 hours of age at the time of randomisation; Infants with ventilatory oxygen requirement > 70%; Attending clinician considers infant not suitable to participate because of other serious congenital abnormalities, or the infant's condition appears terminal.
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Please refer to this study by its identifier: NCT00934700

United Kingdom
Imperial College Academic Healthcare Trust
London, United Kingdom, W12 0HS
Sponsors and Collaborators
Imperial College London
University College London Hospitals
Guy's and St Thomas' NHS Foundation Trust
Principal Investigator: Denis Azzopardi, MD Imperial College London
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Imperial College London Identifier: NCT00934700     History of Changes
Other Study ID Numbers: prot-002-2009
Study First Received: July 7, 2009
Last Updated: October 27, 2014

Keywords provided by Imperial College London:
perinatal asphyxia

Additional relevant MeSH terms:
Brain Diseases
Brain Ischemia
Hypoxia-Ischemia, Brain
Asphyxia Neonatorum
Body Temperature Changes
Signs and Symptoms
Central Nervous System Diseases
Nervous System Diseases
Cerebrovascular Disorders
Vascular Diseases
Cardiovascular Diseases
Hypoxia, Brain
Pathologic Processes
Wounds and Injuries
Infant, Newborn, Diseases
Neuroprotective Agents
Anesthetics, Inhalation
Anesthetics, General
Central Nervous System Depressants
Physiological Effects of Drugs
Protective Agents processed this record on May 23, 2017