World first for British hospital as baby given rare treatment

Riley Joyce received the life-transforming treatment using xenon gas at St Michael's Hospital, Bristol, when suffering from lack of oxygen.

Riley was delivered at the Royal United Hospital, Bath, in a critical condition. He had no pulse and needed to be resuscitated and was transferred to Bristol after his brainwaves 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, his 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, a specialist in neonatal neuroscience at the University of Bristol, said yesterday: "After seven days, Riley was alert, able to look at his mother's face, hold up his head and begin to take milk."

The pioneering technique was developed by Prof Thoresen 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.

Prof 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 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 so it can cost up to 30 per litre."

He continued: "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.

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

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

Oxygen fears for newborn

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 Marianne Thoresen first

started "cooling" babies in 1998, showing that the procedures could reduce damage in the newborn brain.