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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.

Contact Information:

Thilipan Thaventhiran
thilipan.thaventhiran@kcl.ac.uk


Dr Sudhin Thayyil
s.thayyil@imperial.ac.uk


Reema Garegrat
r.garegrat@imperial.ac.uk


Thilipan Thaventhiran
tt206@ic.ac.uk


Dr Sudhin Thayyil
s.thayyil@imperial.ac.uk


Dr Hatty Bird
hatty.bird@nihr.ac.uk


Study Team
comet@imperial.ac.uk


Jana Vaskova
jana.vaskova@nihr.ac.uk


Study Location:

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English | Cymraeg
Be Part of Research - Trial Details - Cooling in Mild Encephalopathy (COMET)

Cooling in Mild Encephalopathy (COMET)

Medical Conditions

Other disorders originating in the perinatal period


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


Despite the lack of evidence on safety or efficacy, many clinicians offer whole body therapeutic hypothermia to infants with mild hypoxic ischaemic encephalopathy, and even to those without any encephalopathy. Such a wide variation in clinical practice within the NHS not only leads to poorer outcomes and may harm infants who would have otherwise done well, but masks improvements in obstetric care and increase litigations.

The COMET trial will establish the safety and efficacy of whole-body hypothermia for mild hypoxic ischaemic encephalopathy, inform national and international guidelines, and will establish uniform practice across the NHS.

Primary objective
To examine if whole-body hypothermia to 33.5 +0.5°C initiated within 6h of birth and continued for 72h, improves cognitive development at two years of age after mild hypoxic ischaemic encephalopathy compared with targeted normothermia at 36.5 +0.5 °C.

Secondary objectives
1. To compare the adverse events in the whole-body hypothermia and targeted normothermia groups.

2. To estimate the cost-effectiveness and economic value of whole-body hypothermia for mild encephalopathy from an NHS and personal social services (PSS) perspective.

COMET is a phase III prospective multi-centre open label two-arm randomised controlled trial with internal pilot and masked outcome assessments. All babies born at or after 36 weeks and requiring prolonged resuscitation at birth (defined as continued resuscitation at 10 minutes after birth or 10-minute Apgar score less than 6) or those with severe birth acidosis admitted to the neonatal unit will be screened. 426 eligible babies will be recruited from six operational delivery networks (ODN) involving a total of 60 NHS hospitals.

The primary outcome is the mean cognitive composite score from the at 24 months. Secondary outcomes will include survival without any neurodisability and microcephaly. Short term outcomes include short term neonatal morbidity and brain injury scores on MR imaging.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

15 Mar 2024 01 Jul 2027

Observational and Interventional

Type: Device;Management of Care;Active Monitoring;



You can take part if:



You may not be able to take part if:


1) Infants who meet the BAPM criteria for whole-body hypothermia 2) Infants without encephalopathy defined as less than two abnormalities on structured neurological examination. 3) Infants with major congenital or chromosomal anomalies identified prior to randomisation. 4) Infants with birthweight < 1800g. 5) Infants who have already received sedation, muscle relaxation, or anti-convulsants prior to neurological assessment. 6) Infants already enrolled in interventional studies.


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • Queen's Hospital
    Rom Valley Way
    Romford
    Essex
    RM7 0AG
  • Whipps Cross University Hospital
    Whipps Cross Road
    London
    Greater London
    E11 1NR
  • Bradford Royal Infirmary
    Duckworth Lane
    Bradford
    West Yorkshire
    BD9 6RJ
  • Homerton University Hospital
    Homerton Row
    London
    Greater London
    E9 6SR
  • King's College Hospital (denmark Hill)
    Denmark Hill
    London
    Greater London
    SE5 9RS
  • Northwick Park Hospital
    Watford Road
    Harrow
    Middlesex
    HA1 3UJ
  • Luton & Dunstable Hospital
    Lewsey Road
    Luton
    Bedfordshire
    LU4 0DZ
  • Derriford Hospital
    Derriford Road
    crownhill
    Plymouth
    Devon
    PL6 8DH
  • Royal Devon & Exeter Hospital (wonford)
    Barrack Road
    Exeter
    Devon
    EX2 5DW
  • Hillingdon Hospital
    Pield Heath Road
    Uxbridge
    Middlesex
    UB8 3NN
  • University Hospital (coventry)
    Clifford Bridge Road
    Coventry
    West Midlands
    CV2 2DX
  • Leicester Royal Infirmary
    Infirmary Square
    Leicester
    Leicestershire
    LE1 5WW
  • Liverpool Womens Hospital
    Crown Street
    Liverpool
    Merseyside
    L8 7SS
  • The Royal Victoria Infirmary
    Queen Victoria Road
    Newcastle Upon Tyne
    Tyne And Wear
    NE1 4LP
  • St Michael's Hospital
    Southwell Street
    Bristol
    BS2 8EG
  • Addenbrooke's Hospital
    Hills Road
    Cambridge
    Cambridgeshire
    CB2 0QQ
  • St Mary's Hospital (hq)
    Praed Street
    London
    Greater London
    W2 1NY
  • Clarendon Wing, Leeds General Infirmary
    Belmont Grove
    Leeds
    West Yorkshire
    LS2 9NS
  • Nottingham University Hospitals NHS Trust - Queen's Medical Centre Campus
    Nottingham University Hospital
    derby Road
    Nottingham
    Nottinghamshire
    NG7 2UH
  • John Radcliffe Hospital
    Headley Way
    headington
    Oxford
    Oxfordshire
    OX3 9DU
  • The Great Western Hospital
    Marlborough Road
    Swindon
    Wiltshire
    SN3 6BB
  • Heartlands Hospital
    Bordesley Green East
    bordesley Green
    Birmingham
    West Midlands
    B9 5SS
  • Royal Preston Hospital
    Sharoe Green Lane North
    fulwood
    Preston
    Lancashire
    PR2 9HT
  • The James Cook University Hospital
    Marton Road
    Middlesbrough
    Cleveland
    TS4 3BW
  • St Thomas' Hospital
    Westminster Bridge Road
    London
    Greater London
    SE1 7EH
  • Gloucestershire Royal Hospital
    Great Western Road
    Gloucester
    Gloucestershire
    GL1 3NN
  • Southmead Hospital
    Southmead Road
    westbury-on-trym
    Bristol
    Avon
    BS10 5NB
  • Whiston Hospital
    Warrington Road
    Prescot
    Merseyside
    L35 5DR
  • East Surrey Hospital
    Canada Avenue
    Redhill
    Surrey
    RH1 5RH
  • Queen Charlotte's Hospital
    Du Cane Road
    London
    Greater London
    W12 0HS
  • Newham General Hospital
    Glen Road
    London
    Greater London
    E13 8SL
  • Darent Valley Hospital
    Darenth Wood Road
    Dartford
    Kent
    DA2 8DA
  • William Harvey Hospital (ashford)
    Kennington Road
    willesborough
    Ashford
    Kent
    TN24 0LZ
  • Worthing Hospital
    Lyndhurst Road
    Worthing
    West Sussex
    BN11 2DH
  • The Tunbridge Wells Hospital
    Tonbridge Road
    pembury
    Tunbridge Wells
    Kent
    TN2 4QJ
  • Royal Sussex County Hospital
    Eastern Road
    Brighton
    BN2 5BE
  • Burnley General Hospital
    Casterton Avenue
    Burnley
    Lancashire
    BB10 2PQ
  • Royal Bolton Hospital
    Minerva Road
    farnworth
    Bolton
    Lancashire
    BL4 0JR
  • Princess Royal University Hospital
    Farnborough Common
    Orpington
    Kent
    BR6 8ND
  • Medway Maritime Hospital
    Windmill Road
    Gillingham
    Kent
    ME7 5NY

Jana Vaskova
jana.vaskova@nihr.ac.uk


Study Team
comet@imperial.ac.uk


Thilipan Thaventhiran
tt206@ic.ac.uk


Dr Sudhin Thayyil
s.thayyil@imperial.ac.uk


Dr Sudhin Thayyil
s.thayyil@imperial.ac.uk


Dr Hatty Bird
hatty.bird@nihr.ac.uk


Thilipan Thaventhiran
thilipan.thaventhiran@kcl.ac.uk


Reema Garegrat
r.garegrat@imperial.ac.uk



The study is sponsored by Imperial College of Science, Technology and Medicine and funded by NIHR Evaluation, Trials and Studies Co-ordinating Centre (NETSCC) .




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for Trial ID: CPMS 58789

Last updated 16 January 2026

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