Melatonin Treatment for Newborn Infants With Moderate to Severe Hypoxic Ischemic Encephalopathy
Status:
Withdrawn
Trial end date:
2018-11-01
Target enrollment:
Participant gender:
Summary
During the birth process certain conditions can cause oxygen delivery and/or blood flow to
the baby's brain to become interrupted. This can cause permanent brain damage. Brain damage
occurs in two phases. The first occurs at the time of injury when brain cells in the affected
area 'die'. There is nothing that can be done about this. The second phase of injury occurs
over the next few days. This second phase is caused by inflammation and release of toxic
chemicals from the injured site. Cooling the baby to a temperature of 92.5° F, for 3 days has
been shown to reduce the second phase of injury and bran death. All babies will receive the
benefit of cooling. Although cooling helps it does not completely stop the second phase of
injury.
Melatonin is a naturally occurring hormone that is produced by the brain, and helps regulate
the sleep-wake cycle. It has the potential to stop the second phase of brain injury by
inhibiting inflammation and release of toxic chemicals. The reason for this research is to
find out if melatonin can or cannot improve the outcome of babies with this kind of brain
damage. Every baby enrolled in the study has a 50:50 chance of getting melatonin. A total of
six doses of medicine will be given. The baby's brain function will be assessed by an EEG,
brain oxygen monitoring, and a neurologic examination at 18 months of life. All of these are
routinely used as part of standard care for patients with this kind of problem. The only
difference is that half the babies enrolled in the study will get the drug called melatonin
and the other half will receive placebo. The dose of melatonin being used in the study is
higher than the amount normally produced by the body. No side-effects of this dose have been
reported in other research studies using melatonin in newborn and premature babies.