Hypothermia's Effect on Hepatitis B Vaccination

Study Overview
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Brief Summary
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The purpose of the research is to determine if the Hepatitis B vaccine after birth provides enough protection after cooling for Hypoxic Ischemic Encephalopathy (HIE). To do this, Hepatitis B titers (blood sample) would be taken before, during, and after administering of the Hepatitis B vaccine series to measure efficacy of the vaccine.

Detailed Description
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Despite the current research on Hypoxic Ischemic Encephalopathy (HIE), and the known effects of hypothermia on acute immune response, the effect of the hypothermia protocol for HIE on the efficacy of the Hepatitis B vaccine is still unknown. We plan to measure anti-hepatitis B surface antibodies at intervals prior, during, and after the primary Hepatitis B vaccine schedule for individuals with HIE to see if there is any effect on efficacy due to the Hypothermia protocol.

Official Title
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Efficacy of the Hepatitis B Vaccination Post Hypothermia for Hypoxic Ischemic Encephalopathy

Conditions
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Hypoxic-Ischemic Encephalopathy, Hepatitis B Vaccination, Hypothermia, Newborn

Intervention / Treatment
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* Other: Hypothermia Protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: > 34 weeks' gestation at birth as measured by best obstetrical estimates > 1500 grams birth weight Clinical signs of asphyxia or documented periods of hypoxic ischemia with no cyanotic cardiac malformations and no known congenital infections. Documented period of hypoxic ischemia: Venous Cord gas pH < 7.0 or initial newborn blood gas pH < 7.1 Base deficit > 13 on venous cord gas or initial newborn blood gas Apgar score < 5 at 10 minutes Prolonged, sustained fetal bradycardia (HR <80) for > 15 minutes in utero by doppler or fetal heart rate monitoring Need for continued resuscitation after 5 minutes (bag-valve mask ventilation with/or without chest compressions) due to the absence of respiratory effort Documented postnatal oxygen saturation < 70% or PaO2 < 35 for > 20 minutes by 2 ABGs, not due to cyanotic heart disease, accompanied by hypotension (mean BP< 35), cardiac arrest with chest compressions, or hemorrhage (requiring 20cc/kg volume replacement) Parental willingness for infant to receive Hepatitis B vaccine. Exclusion Criteria: - Positive maternal Hepatitis B status during pregnancy

Ages Eligible for Study
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Minimum Age: 0 Hours
Maximum Age: 72 Hours

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hypothermia Protocol<br> | Other: Hypothermia Protocol<br>* Subject's who will be treated with the hypothermia protocol for Hypoxic Ischemic Encephalopathy as standard of care.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determine efficacy of the Hepatitis B vaccine in individuals who are treated with routine care of Hypothermia for Hypoxic Ischemic Encephalopathy | Response to vaccine will be measured by the previously researched protective level of anti-hepatitis B surface antibodies of ≥ 10 mIU/ml. We hypothesize that hypothermia to 33-33.5oC for 72h in near-term and term infants with Hypoxic Ischemic Encephalopathy will decrease the infant's immune response to the primary Hepatitis B vaccine series. | 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hypoxic Ischemic Encephalopathy, Hepatitis B vaccination