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Jane Weakley welcomes CYRIL technology to test new-borns at risk of cerebral palsy

Jane Weakley
Researchers at University College London (UCL) have developed a non-invasive monitoring system, small enough to take into neonatal intensive care units, which shines infrared light into new-born babies' brains to detect possible brain damage within a few hours of birth.

The device, known as CYRIL (CYtochrome-c-oxidase Research Instrument and appLication), sends hundreds of wavelengths into brain tissue which feedback detailed information to a digital camera about oxygen and metabolism levels. This information can then be used to identify brain injury severity in babies who may have been deprived of oxygen at birth and risk developing cerebral palsy.

This early detection, which is currently being trialled at University College Hospital and has been used on around 100 babies, offers doctors the chance to intervene immediately and reduce the possibility of permanent disability or death by cooling the baby and monitoring if the treatment is having an effect. The results can be obtained in around 20 minutes.

An internal computer calculates changes in light colour and informs doctors whether brain cells are damaged or healthy and how they are using oxygen in real time. Researchers have described the early results as 'very promising'.

Currently, when doctors suspect a baby may have suffered oxygen deprivation, the procedure is to wait several days before performing an MRI scan which may then prove inconclusive. Many parents are simply sent home with their new baby to wait to see if symptoms develop, which can take months or even years to become apparent. In the meantime, they must often cope with disruptive and unsettled behaviour and development problems that cannot be properly assessed until the child is older.

CYRIL could change the lives of parents and their children with cerebral palsy by offering early diagnosis of brain injury and immediate therapeutic brain cooling, helping families better prepare for the way ahead by devising practical solutions and targeting specific care to help children develop to their best ability and achieve the best possible life for the whole family.

From a legal perspective, it would allow prompt investigation into what happened to cause the brain injury and whether there is a case of medical negligence.

At the end of 2018, I achieved a structured settlement of £34m in a complex birth injury case for a 14-year-old boy. The boy, who is protected under an anonymity order, was delivered in poor condition at Newham District Hospital. The delivery was complicated by shoulder dystocia and he sustained a short period of near total hypoxic ischaemic injury and was born in very poor condition. He required vigorous resuscitation and suffered seizures in the neonatal period.

Initially it was thought he was developing well, but by eight months, development delay was identified. MRI was not performed until two years and a diagnosis of cerebral palsy was made at five years. There then began a long and difficult journey for the boy and his family as his behavioural and cognitive problems became increasingly severe.

CYRIL may have been able to identify the severity of the boys injury at a very early stage which may have resulted in different therapeutic treatment and more information for the family on how the boy would develop, rather than a 'wait and see' approach which delayed diagnosis and appropriate care.

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