[ISS-L6] Treatment 2

[L-26] How to protect the neonatal brain

Alistair J. GUNN (University of Auckland, New Zealand)

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)

INSTITUTION AND LOCATION DEGREE(if applicable) Completion Date MM/YYYY FIELD OF STUDY
Otago University, New Zealand MBChB 12/1982 Medicine
Royal Australasian College of Physicians FRACP 6/1992 Paediatrics
University of Auckland, New Zealand PhD 5/1993 Paediatrics

A. Personal Statement
My programme of research is in the mechanisms, detection, and treatment of perinatal and prenatal brain injury. I have played a leading role in developing models of injury in the fetal sheep that allow direct translation of preclinical findings to the clinic. I am best known for my preclinical and clinical studies of neuroprotection with head cooling after perinatal asphyxia. We knew that the great majority of acute brain injury in term infants evolved after the time of birth, offering the tantalizing possibility that it might be possible to intervene to improve outcomes. Hypothermia has been proposed for resuscitating infants after perinatal asphyxia for over 300 years, but there was insufficient evidence to underpin clinical testing. My studies used a well-defined large animal model of acute cerebral ischemia to prove for the first time ever that mild cooling initiated well after the end of severe fetal oxygen deprivation can be neuroprotective, to define the optimal depth and duration of cooling and to systematically explore the window of opportunity for improved outcomes. These studies provided the key parameters for subsequent clinical translation. More recently I led a study that further showed that extending the duration of mild hypothermia from 3 to 5 days did not improve neural outcomes.