World first as new-born baby is given xenon gas

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A British hospital has become the first in the world to give xenon gas to a stricken new-born baby to prevent it suffering brain injury.

Riley Joyce received the life-transforming treatment at St Michael's Hospital, Bristol, when he was taken there suffering from lack of oxygen.



Riley was delivered at the Royal United Hospital, Bath in a critical condition, with no pulse and needed to be resuscitated. He was transferred to Bristol after his brain waves gave abnormal readings.



On arrival his parents were told there was still a "50:50" chance of permanent injury and disability.



They were asked if they would agree to Riley being the first baby ever to inhale xenon gas as an experimental treatment that might improve his chances of full recovery.



After Prof Marianne Thoresen and her colleague Dr James Tooley had stabilised Riley at 33.5 degrees Celsius, Riley's breathing machine was connected to the xenon delivery system for three hours.



Riley was kept cool for 72 hours, then slowly rewarmed and was able to breathe without the machine on day five.



Prof Thoresen said today: "After seven days, Riley was alert, able to look at his mother's face, hold up his head and begin to take milk."



Riley's parents, Dave and Sarah Joyce, said today: "We are delighted that Riley is doing so well and we are extremely grateful that we were given this opportunity.



"Marianne was so passionate about the treatment and we truly believe that she had and still has the best interests of Riley in mind.



"It was traumatic to see our baby not breathing, but seeing the ambulance coming to collect Riley to take him to Bristol gave us hope that something could be done to help him. We would like to thank all the team at St Michael's Hospital for everything they have done for us."



The pioneering technique was developed by 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 School of Medicine.



This study is being funded by Sparks, the children's medical research charity.



In the UK, 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 or blood supply at birth. This can lead to lifelong problems such as cerebral palsy.



St Michael's Hospital and the University of Bristol has pioneered new treatments for brain injury in babies since Prof Thoresen first started "cooling" babies in 1998, showing that the procedures could reduce damage in the newborn brain.



Clinical trials have now proven that mild cooling by only a few degrees for 72 hours is a safe and beneficial treatment.



But cooling only partially reduces disability and does not prevent it in all babies. The search has been to find a second treatment that could be added to further reduce disability.



Professor Marianne Thoresen said: "Xenon is a very rare and chemically inert anaesthetic gas found in tiny quantities in the air that we breathe. In 2002 John Dingley and I realised the potential xenon and cooling might have in combination to further reduce disability.



"Over the past eight years, we have shown in the laboratory that xenon doubles the protective effect of cooling on the brain; however we faced the challenge of how to safely and effectively deliver this rare and extremely expensive gas to newborn babies."



Dr Dingley has been developing equipment in Swansea for xenon anaesthesia in adults for more than 10 years and has invented a machine to successfully deliver the gas to babies.



His creation takes the exhaled gas, removes any waste products from it and re-circulates it to be breathed again without any loss at all to the outside air.



Dr Dingley, said: "A key design feature of this machine is that it is very efficient, using less than 200ml of xenon per hour - less than the volume of a soft drinks can. Xenon is a precious and finite resource and difficult to extract so it can cost up to £30 per litre."



He continued: "Despite these challenges, the lack of side-effects and brain protecting properties of xenon make it uniquely attractive as a potential treatment to apply alongside cooling in these babies."



The device is now authorised for clinical trials and will be used on at least 12 babies over the coming months.



Professor Thoresen and Dr Dingley's previously successful research work into cooling and the increased survival chances offered by xenon have been funded through the children's medical research charity Sparks, which has committed almost £800,000 to the team's pioneering work.



Sparks, a children's medical research charity, has committed almost £1.5m to cooling research in recent years, including the "CoolCap" now being widely used in the NHS.



Sparks president and England World Cup-winning hero Sir Geoff Hurst said: "Congratulations to Professor Thoresen, Dr Dingley and the rest of their dedicated team on this fantastic success.



"This world first underscores the importance of the charity's funding and makes every pound worthwhile. To me, personally, it's even more important than scoring the winning goal in a World Cup Final."

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