Abstract
Purpose of Review Therapeutic hypothermia reduces death or disability in term and near-term infants with moderate-severe
hypoxic-ischemic encephalopathy. Nevertheless, many infants still survive with disability, despite hypothermia, supporting
further research in to ways to further improve neurologic outcomes.
Recent Findings Recent clinical and experimental studies have refined our understanding of the key parameters for hypothermic
neuroprotection, including timing of initiation, depth, and duration of hypothermia, and subsequent rewarming rate. However,
important knowledge gaps remain. There is encouraging clinical evidence from a small phase II trial that combined treatment of
hypothermia with recombinant erythropoietin further reduces risk of disability but definitive studies are still needed.
Summary In conclusion, recent studies suggest that current protocols for therapeutic hypothermia are near-optimal, and that the
key to better neurodevelopmental outcomes is earlier diagnosis and initiation of hypothermia after birth. Further research is
essential to find and evaluate ways to further improve outcomes after hypoxic-ischemic encephalopathy, including add-on
therapies for therapeutic hypothermia and preventing pyrexia during labor and delivery.
hypoxic-ischemic encephalopathy. Nevertheless, many infants still survive with disability, despite hypothermia, supporting
further research in to ways to further improve neurologic outcomes.
Recent Findings Recent clinical and experimental studies have refined our understanding of the key parameters for hypothermic
neuroprotection, including timing of initiation, depth, and duration of hypothermia, and subsequent rewarming rate. However,
important knowledge gaps remain. There is encouraging clinical evidence from a small phase II trial that combined treatment of
hypothermia with recombinant erythropoietin further reduces risk of disability but definitive studies are still needed.
Summary In conclusion, recent studies suggest that current protocols for therapeutic hypothermia are near-optimal, and that the
key to better neurodevelopmental outcomes is earlier diagnosis and initiation of hypothermia after birth. Further research is
essential to find and evaluate ways to further improve outcomes after hypoxic-ischemic encephalopathy, including add-on
therapies for therapeutic hypothermia and preventing pyrexia during labor and delivery.
| Original language | English |
|---|---|
| Article number | 2 |
| Number of pages | 10 |
| Journal | Current Neurology and Neuroscience Reports |
| Volume | 19 |
| Issue number | 2 |
| Early online date | 14 Jan 2019 |
| DOIs | |
| Publication status | Published - Jan 2019 |
Keywords
- Neonatal encephalopathy
- Therapeutic hypothermia
- Neonatal neuroprotection
- Fetal sheep
- Erythropoietin
- Neonatal examination