Clinical Trials Logo

Clinical Trial Summary

Hypoxic-ischemic encephalopathy (HIE) is a serious birth complication due to systemic asphyxia which occurs in about 20 of 1,000 full-term infants and nearly 60% of premature newborns. Between 10-60% of babies who exhibit HIE die during the newborn period and up to 25% of the HIE survivors have permanent neurodevelopmental handicaps in the form of cerebral palsy, mental retardation, learning disabilities, or epilepsy. HIE also has a significant financial impact on the health care system. In the state of Florida, the total cost for initial hospitalization is $161,000 per HIE patient admitted, but those costs don't take into account the life-long costs.

Current monitoring and evaluation of HIE, outcome prediction, and efficacy of hypothermia treatment rely on a combination of a neurological exam, ultrasound, magnetic resonance imaging (MRI) and electroencephalography (EEG). However, these methods do a poor job in identifying non-responders to hypothermia. MRI requires transport of the neonate with a requisite 40-45 min scan, which is not appropriate for unstable neonates. Moreover, the amplitude integrated EEG (aEEG), a common bedside monitoring technique currently used in these patients to assess candidates and predict outcomes prior to hypothermia, can be adversely affected by hypothermia itself and the patient may not appear to improve until re-warming. Consequently, the development of a simple, inexpensive, non-invasive, rapid biochemical test is essential to identify candidates for therapeutic hypothermia, to distinguish responders from non-responders and to assess outcome. This research is the first step needed to treat neonates with HIE employing a personalized medical approach using serum proteins GFAP and UCH-L1 as biomarkers and by monitoring neonates responses to therapeutic hypothermia. These biomarkers will aid in the direct care by providing a rapid test to predict outcomes and select candidates who are likely to benefit from therapeutic hypothermia and gauge a response to the neuroprotective intervention.


Clinical Trial Description

Control Neonates will be easily obtained from a single center, Shands UF. The control samples will be derived from two groups: (1) "Healthy Controls" will be healthy neonates with Apgar scores ≥ 7 at 1 minute and ≥ 8 at 5 minutes and no other medical problems associated with neurologic injury such as hyperbilirubinemia or hypoglycemia. This group will establish a negative control and will have 500-800µL of blood collected at the time of standard blood metabolic screens (at 24 and 48 hours of life). (2) "Clinical Controls" will be healthy neonates evaluated for jaundice, with multiple blood samples drawn between birth and 48 hours of life to monitor serum bilirubin concentrations. They will have an additional 0.8-1 mL of blood drawn at the time of any clinical sample (venous or heel stick) is performed. In addition, neonates will be excluded if they show signs of sepsis or hypoglycemia (< 40). The neonates' bilirubin will be plotted using the American Academy of Pediatrics risk-based stratification method, the Bhutani monogram (which is a based on the serum bilirubin concentration and the hours of life). Clinical control neonates must have low-risk or low-intermediate bilirubin concentrations, with virtually no risk of brain injury. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT02349672
Study type Observational
Source University of Florida
Contact
Status Completed
Phase
Start date March 2016
Completion date July 2017

See also
  Status Clinical Trial Phase
Withdrawn NCT02551003 - Neuroprotective Effect of Autologous Cord Blood Combined With Therapeutic Hypothermia Following Neonatal Encephalopathy Phase 1/Phase 2
Completed NCT02683915 - Reno-protective Effect of Brain Cooling in Newborn With Hypoxia
Recruiting NCT01962233 - Umbilical Cord Derived Mesenchymal Stem Cells Therapy in Hypoxic Ischemic Encephalopathy Phase 1
Completed NCT01471015 - Darbe Administration in Newborns Undergoing Cooling for Encephalopathy Phase 1/Phase 2
Completed NCT01683383 - California Transport Cooling Trial N/A
Completed NCT01649648 - Autologous Cord Blood Cells for Brain Injury in Term Newborns Phase 1
Completed NCT01481207 - Magnetic Resonance Imaging and Spectroscopy Biomarkers of Neonatal Hypoxic Ischemic Encephalopathy
Withdrawn NCT00993564 - Magnetic Resonance Imaging (MRI) Thermal Imaging of Infants Undergoing Cooling for Hypoxic Ischemic Encephalopathy (HIE) N/A
Completed NCT00945789 - Erythropoietin in Infants With Hypoxic Ischemic Encephalopathy (HIE) Phase 1/Phase 2
Completed NCT00097097 - Neonatal Resuscitation in Zambia Phase 3
Recruiting NCT02621944 - Melatonin as a Neuroprotective Therapy in Neonates With HIE Undergoing Hypothermia Early Phase 1
Not yet recruiting NCT02605018 - Neuroprotective Effect of Autologous Cord Blood Combined With Therapeutic Hypothermia Following Neonatal Encephalopathy Phase 1/Phase 2
Withdrawn NCT01128673 - MRI Thermal Imaging of Infants Undergoing Cooling for Hypoxic Ischemic Encephalopathy(HIE) N/A
Completed NCT01732146 - Efficacy of Erythropoietin to Improve Survival and Neurological Outcome in Hypoxic Ischemic Encephalopathy Phase 3
Completed NCT02826941 - Moderate Hypothermia in Neonatal Hypoxic Ischemic Encephalopathy Phase 2
Active, not recruiting NCT01138176 - Whole Body Cooling Using Phase Changing Material Phase 1/Phase 2
Recruiting NCT02578823 - Targeted Temperature Management After In-Hospital Cardiac Arrest N/A
Terminated NCT01765218 - Topiramate in Neonates Receiving Whole Body Cooling for Hypoxic Ischemic Encephalopathy Phase 1/Phase 2
Completed NCT01241019 - Safety and Efficacy of Topiramate in Neonates With Hypoxic Ischemic Encephalopathy Treated With Hypothermia Phase 2
Completed NCT00620711 - Pilot Study of Head Cooling in Preterm Infants With Hypoxic Ischemic Encephalopathy Phase 1