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| http://dx.doi.org/10.1038/pr.2012.148 | DOI Listing |
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Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia?
Metabolites
November 2024
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy.
Article Synopsis
- Oxidative stress-related diseases in newborns are caused by an imbalance between pro-oxidants and antioxidants, affecting both term and preterm infants, and are associated with conditions like hypoxic ischemic encephalopathy (HIE) and retinopathy of prematurity (ROP).
- A comprehensive review of literature from 2012-2024 highlighted various antioxidant therapies—including melatonin and N-acetylcisteine—that have been investigated for their effectiveness in treating these oxidative stress-related diseases in newborns.
- Current findings suggest that therapies like melatonin, allopurinol, and stem cells could serve as potential alternatives to the standard treatment of therapeutic hypothermia for newborns suffering
Chorioamnionitis and Two-Year Outcomes in Infants with Hypoxic-Ischemic Encephalopathy.
J Pediatr
December 2024
Division of Neonatology, Department of Pediatrics, Fetal Neonatal Institute, Children's Hospital Los Angeles, Keck School of Medicine University of Southern California, Los Angeles, CA.
Objective: To determine if chorioamnionitis is associated with an increased risk of adverse 2-year outcomes among infants with hypoxic-ischemic encephalopathy (HIE).
Study Design: This cohort study included all infants with moderate to severe HIE treated with therapeutic hypothermia and enrolled on the High-dose Erythropoietin for Asphyxia and Encephalopathy Trial. Clinical chorioamnionitis (CC) was defined as a diagnosis made by a treating obstetrician and histologic chorioamnionitis (HC) was defined as placental inflammation observed on histology.
Assessing Early Severity of Hypoxic-Ischemic Encephalopathy: The Role of Electroencephalogram Background in Addition to Sarnat Exam.
J Pediatr
November 2024
Department of Pediatrics, University of California San Francisco, San Francisco, CA; Department of Neurology and the Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
Objective: To assess the relationship between the Sarnat exam, early electroencephalogram (EEG) background, and death or neurodevelopmental impairment (NDI) at age 2 years among neonates with moderate to severe hypoxic-ischemic encephalopathy treated with therapeutic hypothermia.
Study Design: Neonates enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy trial with EEG (n = 463) or amplitude-integrated electroencephalogram (n = 15) reports available on the first day after birth were included in this cohort study. A Sarnat exam was performed between 1 and 6 hours after birth, and neonates were classified into 3 groups of increasing severity based on the number of severe features (none, 1-2, or 3+).
On target dosing: erythropoietin exposure in neonates with hypoxic-ischemic encephalopathy in the HEAL trial.
Pediatr Res
November 2024
Departments of Neurology, University of California, San Francisco, CA, USA.
Background: The High-Dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) trial for neonates with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia demonstrated no neurodevelopmental benefit but was associated with a higher rate of serious adverse events (SAEs). Understanding if targeted Epo plasma exposures were achieved in the HEAL trial and if SAEs were associated with higher exposures would help future therapeutic programs of Epo as a candidate neuroprotective treatment.
Methods: Ancillary study of a subset of HEAL neonates who received Epo (1000 U/kg IV on days 1, 2, 3, 4, and 7) and had plasma drug concentrations measured.
Adjuvant High-Dose Erythropoietin With Delayed Therapeutic Hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy.
Pediatr Neurol
December 2024
Faculty of Medicine, Division of Neurology, Department of Pediatrics, Chiang Mai University, Chiang Mai, Thailand. Electronic address:
Background: To evaluate the benefits of high-dose erythropoietin (EPO) combined with therapeutic hypothermia (TH) on brain magnetic resonance imaging (MRI) scores and neurodevelopmental outcomes in neonates with moderate to severe hypoxic-ischemic-ecephalopathy (HIE), especially in neonates who received TH between six to 12 hours of birth.
Methods: This prospective, single-blind, randomized, placebo-controlled trial enrolled term newborns with moderate to severe HIE admitted to neonatal intensive care unit between April 2018 and April 2022. Hypothermia was started within 12 hours of birth.
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