British doctors have become the first in the world to administer xenon gas to stricken newborn babies while travelling in an ambulance.
Two babies at risk of brain injury after being deprived of oxygen during birth were given the inert gas as they were transferred between hospitals.
Using xenon to prevent brain injuries in newborns was first performed in 2010 and has since been used on a limited number of specialist wards in the UK. It is currently undergoing clinical trials in Bristol.
The pioneering treatment must be carried out within a tight timeframe in order to be effective – meaning many sick babies have missed out as they could not reach a participating hospital in time.
But in a world first, experts from the universities of Bristol and Swansea have built equipment which allows xenon gas to be administered in a transportable incubator.
This means babies can receive xenon and cooling therapy immediately after birth and during ambulance journeys between neonatal units.
Every year, more than 1,000 otherwise healthy babies born at full term die or suffer brain injury caused by a lack of oxygen and blood supply.
Poppy Laker was the second baby in the world to be given xenon during transit after she was deprived of oxygen during her birth last Wednesday.
Parents Stephen and Kelly Laker, from Paulton, Somerset, gave doctors permission to give her the treatment 30 minutes after her birth after being warned she was at risk of brain injury. Poppy was delivered with forceps after her shoulder became stuck, squashing her umbilical cord, during the 16-hour labour.
The baby, the Lakers' first, was not breathing when she was born at Royal United Hospital in Bath at 5.17pm.
Mr Laker, 29, an office worker, said: "They showed us our baby and then whisked her away for resuscitation. That was the most horrible part. It was the best and worst day of our lives. A doctor came and spoke to us and explained the cooling and xenon. We had a 30-minute window to decide whether Poppy should have the treatment. We decided we had to do it – any chance of getting her healthy again."
Poppy was immediately taken from the RUH to Bristol's St Michael's Hospital, where the treatment of cooling and xenon gas treatment is being developed.
Her parents said Poppy was doing well, had been taken off a ventilator and all medication and now just had a feeding tube to help her eat. She returned to the RUH on Thursday after an MRI scan.TIMING 'ABSOLUTELY VITAL' IN BID TO PREVENT BRAIN INJURY
A team of specialists at St Michael's Hospital started cooling babies in 1998, reducing their temperatures by a few degrees to lower the risk of brain injury.
They first gave xenon gas to a baby in 2010. It is thought that adding xenon treatment to cooling could double success rates.
The gas, delivered by the baby's breathing machine, is believed to block processes in the brain that can lead to the death of nerve cells that in turn causes brain damage.
Marianne Thoresen, professor of neonatal neuroscience at the University of Bristol, and Dr John Dingley, consultant anaesthetist and reader in anaesthetics at Swansea University's College of Medicine, have spent ten years developing the treatment. At St Michael's Hospital, xenon and cooling therapy is only administered on newborn babies within five hours of birth to ensure it is as effective as possible. The new equipment can deliver the treatment away from the ward for up to three hours.
Professor Thoresen said: "The timing is absolutely vital. With all types of treatment after brain injury it is important to start as soon as possible. For every hour you wait, the more injury you have.
"This is a rare condition – it is one in 1,000 babies that need to be cooled. It doesn't happen to many babies, but to the ones it does it is a disaster. Of these babies, 70 per cent will have a poor outcome. After cooling, that comes down to 50 per cent. We hope xenon reduces that even further." She added that it would take at least two years before the long-term effects of xenon could be ascertained in babies who had received the treatment.
Dr Dingley said the breakthrough came when he realised that "incredibly expensive" xenon, which costs £75 per minute of treatment, could be transported in two to three-litre bags. Previously, the team had used cylinders containing £20,000 worth of the gas.
He added: "I developed a very compact version of the xenon breathing system we are using in the baby unit that fits a small space on the ambulance.
"This means it can be delivered to the lungs continuously even while the baby is being moved."BACKERS PRAISE 'TALENTED TEAM' OF RESEARCHERS
The xenon and cooling treatment at St Michael's Hospital is being given as part of a £600,000 clinical trial funded by the JP Moulton Charitable Foundation and Sparks (Sport Aiding Medical Research for Kids).
A spokesman for JP Moulton Charitable Trust said: "It is very gratifying to have part-funded such exciting work.
"The team at Bristol are both talented and exceptionally dedicated."
John Shanley, chief executive of Sparks, said: "Each year in the UK, over 3,500 babies die before their first birthday. Funding research that helps prevent, diagnose, treat and cure conditions affecting the health of children is at the heart of what Sparks does.
"We have been committed to funding research into xenon gas and cooling therapy for a number of years and we are pleased to start seeing the outcomes of the wonderful work being done by Professor (Marianne) Thoresen and her team."
Sixteen babies have taken part in the randomised controlled trial at St Michael's, with half given xenon and cooling and the other half standard cooling therapy. The plan is to recruit 84 babies to the trial, the number predicted to prove a difference between the two groups.
