Hypoxic-ischemic encephalopathy (HIE) is one of the leading causes of newborn mortality and morbidity worldwide, and lowering the baby's body temperature—called therapeutic hypothermia—is often used as a treatment. A review in Developmental Medicine and Child Neurology highlights additional therapies for HIE that are being tested with and without concomitant therapeutic hypothermia.
Neonatal HIE is characterized by neurological dysfunction resulting from inadequate oxygen and blood flow to the brain near the time of birth. Therapeutic hypothermia is an established therapy in high-income countries, but many infants still die or experience neurodevelopmental consequences after treatment. Moreover, in low- and middle-income countries, where the burden of HIE is the highest, therapeutic hypothermia was recently shown to be ineffective.
The new review notes that investigational therapies for HIE include agents that block excessive activation of glutamate receptors, drugs that act as antioxidants or anti-inflammatories, and products that target multiple neuroprotective pathways.
"Therapeutic hypothermia for moderate-to-severe neonatal HIE is one of the success stories in newborn care, but there is an urgent need to identify additional therapies that are effective both with and without therapeutic hypothermia," said corresponding author Natalie H. Chan, MD, MPH, of the University of California, San Francisco. "Our paper reviews the promising therapies being evaluated in clinical studies that could close the remaining gap in optimizing outcomes in all babies with HIE."
URL upon publication: https://onlinelibrary.wiley.com/doi/10.1111/dmcn.16184
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