Neonatal encephalopathy and hypoxic-ischemic encephalopathy

Research output: Chapter in Book/Report/Conference proceedingChapter in a book

6 Citations (Scopus)

Abstract

Acute hypoxic-ischemic encephalopathy around the time of birth remains a major cause of death and life-long disability. The key insight that led to the modern revival of studies of neuroprotection was that, after profound asphyxia, many brain cells show initial recovery from the insult during a short "latent" phase, typically lasting approximately 6h, only to die hours to days later after a "secondary" deterioration characterized by seizures, cytotoxic edema, and progressive failure of cerebral oxidative metabolism. Studies designed around this framework showed that mild hypothermia initiated as early as possible before the onset of secondary deterioration and continued for a sufficient duration to allow the secondary deterioration to resolve is associated with potent, long-lasting neuroprotection. There is now compelling evidence from randomized controlled trials that mild to moderate induced hypothermia significantly improves survival and neurodevelopmental outcomes in infancy and mid-childhood.
Original languageEnglish
Title of host publicationNeonatal Neurology
EditorsL De Vries, H Glass
PublisherElsevier
Chapter10
Pages217-237
Number of pages21
Volume162 (3rd series)
ISBN (Electronic)9780444640307
ISBN (Print)9780444640291
DOIs
Publication statusPublished - 12 Aug 2019

Keywords

  • Hypoxic–ischemic encephalopathy
  • Therapeutic hypothermia
  • Apoptosis
  • Necrosis
  • Hypotension
  • Hypoperfusion
  • Animal models
  • Window of opportunity for treatment

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