Dr. J. R. Tooling and his colleagues are exploring this question. Using an animal model of new born piglets exposed to a severe reduction of oxygen for 45 minutes, the investigators considered the effectiveness of using differential cooling in which the brain was profoundly cooled using a head cap, while the remainder of the body was only mildly cooled. Also, the animals were under anesthesia to reduce both total body stress (e.g. cardiac stress) and shivering. The logic is that body stress was increased in reacting to total body cooling and being alert; this indirectly influenced the metabolic activity of threatened brain cells.

The results of his revised method of cooling were “twenty four hours of selected head cooling combined with mild total body cooling during anesthesia is highly protective in the global perinatal hypoxic-ischemic brain injury piglet model.”

Comment: In an experimental, carefully controlled animal model of lower oxygen availability to the newborn animals brain, the immediate use of brain cooling was successful in significantly protecting the threatened brain. The control of total body stress by the use of anesthesia and differential cooling of the brain and body appears to control the factors that defeated the clinical usefulness of brain cooling in the past. If additional studies using animal models demonstrate the same protective effect which no undesirable complications, the stage well be set to try this approach in human infants. Hopefully, this modification in technique will finally provide a useful clinical-intervention to protect the brain of the newborn threatened by a perinatal episode of hypoxia-ischemia.