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N/A N=325 Randomized Treatment

TOBY (TOtal Body hYpothermia): a Study of Treatment for Perinatal Asphyxia

Asphyxia Neonatorum · Hypoxia · Encephalopathy · Seizures

Enrolled (actual)
325
Serious AEs
3.4%
Results posted
May 2016
Primary outcome: Primary: Combined Incidence of Mortality and Severe Neurodevelopmental Disability in Survivors — 74; 86 participants

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Whole body mild induced hypothermia (Procedure)
Age
Pediatric · 0+ yrs
Sex
All
Sponsor
Imperial College London
Primary completion
Nov 2006

Outcome Measures

OutcomeResultp-value
PRIMARY
Combined Incidence of Mortality and Severe Neurodevelopmental Disability in Survivors
74; 86
SECONDARY
Intracranial Haemorrhage
25; 21
SECONDARY
Persistent Hypotension
126; 134
SECONDARY
Pulmonary Haemorrhage
5; 3
SECONDARY
Pulmonary Hypertension
16; 9
SECONDARY
Prolonged Blood Coagulation Time
67; 72
SECONDARY
Culture Proven Sepsis
20; 20
SECONDARY
Necrotising Enterocolitis
1; 0
SECONDARY
Cardiac Arrhythmia
8; 3
SECONDARY
Thrombocytopenia
94; 80
SECONDARY
Major Venous Thrombosis
2; 1
SECONDARY
Renal Failure Treated With Dialysis
0; 0
SECONDARY
Pneumonia
5; 5
SECONDARY
Pulmonary Airleak
9; 3
SECONDARY
Duration of Hospitalisation
12; 13
SECONDARY
Mortality
42; 44
SECONDARY
Severe Neurodevelopmental Disability
32; 42
SECONDARY
Multiple Handicap
21; 33
SECONDARY
Bayley Psychomotor Developmental Index Score (PDI)
27; 37
SECONDARY
Sensorineural Hearing Loss
110; 97
SECONDARY
Epilepsy (Defined as Recurrent Seizures Beyond the Neonatal Period, Requiring Anticonvulsant Therapy at the Time of Assessment)
12; 16
SECONDARY
Microcephaly
24; 28

Summary

Hypothesis: Prolonged whole body cooling in term infants with perinatal asphyxial encephalopathy reduces death and severe neurodevelopmental disability. This study aims to determine whether whole body cooling to 33-34°C is a safe treatment that improves survival, without severe neurological or neurodevelopmental impairments at 18 months, of term infants suffering perinatal asphyxial encephalopathy.

Eligibility Criteria

Inclusion criteria

The infant will be assessed sequentially by criteria A, B and C listed below:

A. Infants =>36 completed weeks gestation admitted to the Neonatal Intensive Care Unit (NICU) with at least one of the following:

  • Apgar score of = 16 mmol/L in umbilical cord or any blood sample (arterial, venous or capillary) within 60 minutes of birth

Infants that meet criteria A will be assessed for whether they meet the neurological abnormality entry criteria (B) by trained personnel:

B. Moderate to severe encephalopathy, consisting of altered state of consciousness (lethargy, stupor or coma) AND at least one of the following:

  • hypotonia
  • abnormal reflexes including oculomotor or pupillary abnormalities
  • absent or weak suck
  • clinical seizures

Infants that meet criteria A & B will be assessed by amplitude-integrated electroencephalogram (aEEG) (read by trained personnel):

C. At least 30 minutes duration of amplitude integrated EEG recording that shows abnormal background aEEG activity or seizures. There must be one of the following:

  • normal background with some seizure activity
  • moderately abnormal activity
  • suppressed activity
  • continuous seizure activity

Exclusion criteria

  • Infants expected to be > 6 hours of age at the time of randomisation
  • Major congenital abnormalities, such as diaphragmatic hernia requiring ventilation, or congenital abnormalities suggestive of chromosomal anomaly or other syndromes that include brain dysgenesis
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00147030). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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