Neonatal encephalopathy due to suspected hypoxic ischemic encephalopathy:pathophysiology,current,and emerging treatments  

作　　者：Carina Corte-Real Babbo Juanita Mellet Jeanne van Rensburg Shakti Pillay Alan Richard Horn Firdose Lambey Nakwa Sithembiso Christopher Velaphi Gugulabatembunamahlubi Tenjiwe Jabulile Kali Melantha Coetzee Mogomane Yvonne Khomotso Masemola Daynia Elizabeth Ballot Michael Sean Pepper 

机构地区：[1]SAMRC Extramural Unit for Stem Cell Research and Therapy,Department of Immunology,Faculty of Health Sciences,Institute for Cellular and Molecular Medicine,University of Pretoria,Room 5‑64,Level 5,Pathology Building,15 Bophelo Road(Cnr.Steve Biko and Dr.Savage Streets),Prinshof Campus,Gezina,Pretoria,South Africa [2]Department of Paediatrics and Child Health,Division of Neonatology,Groote Schuur Hospital,University of Cape Town,Neonatal Unit,Cape Town,South Africa [3]Department of Paediatrics and Child Health,Faculty of Health Sciences,Chris Hani Baragwanath Academic Hospital,University of the Witwatersrand,Johannesburg,South Africa [4]Department of Paediatrics and Child Health,Stellenbosch University,Tygerberg Hospital Neonatal Unit,Cape Town,South Africa [5]Department of Paediatrics and Child Health,Division of Neonatology,Faculty of Health Sciences,Steve Biko Academic Hospital,University of Pretoria,Pretoria,South Africa [6]Department of Paediatrics and Child Health,Faculty of Health Sciences,Kalafong Hospital,University of Pretoria,Pretoria,South Africa [7]Department of Paediatrics and Child Health,Faculty of Health Sciences,Charlotte Maxeke Johannesburg Academic Hospital,University of the Witwatersrand,Johannesburg,South Africa

出　　处：《World Journal of Pediatrics》2024年第11期1105-1114,共10页世界儿科杂志（英文版）

基　　金：supported by the South African Medical Research Council(GIPD 96783);the Bill and Melinda Gates Foundation(INV-022216 and INV-041062).

摘　　要：Background Neonatal encephalopathy(NE)due to suspected hypoxic-ischemic encephalopathy(HIE),referred to as NESHIE,is a clinical diagnosis in late preterm and term newborns.It occurs as a result of impaired cerebral blood flow and oxygen delivery during the peripartum period and is used until other causes of NE have been discounted and HIE is confirmed.Therapeutic hypothermia(TH)is the only evidence-based and clinically approved treatment modality for HIE.However,the limited efficacy and uncertain benefits of TH in some low-to middle-income countries(LMICs)and the associated need for intensive monitoring have prompted investigations into more accessible and effective stand-alone or additive treatment options.Data sources This review describes the rationale and current evidence for alternative treatments in the context of the pathophysiology of HIE based on literatures from Pubmed and other online sources of published data.Results The underlining mechanisms of neurotoxic effect,current clinically approved treatment,various categories of emerging treatments and clinical trials for NE are summarized in this review.Melatonin,caffeine citrate,autologous cord blood stem cells,Epoetin alfa and Allopurinal are being tested as potential neuroprotective agents currently.Conclusion This review describes the rationale and current evidence for alternative treatments in the context of the pathophysiology of HIE.Neuroprotective agents are currently only being investigated in high-and middle-income settings.Results from these trials will need to be interpreted and validated in LMIC settings.The focus of future research should therefore be on the development of inexpensive,accessible monotherapies and should include LMICs,where the highest burden of NESHIE exists.

关 键 词：Brain Cerebrovascular circulation Hypoxia–ischemia Induced hypothermia Neuroprotective agents 

分 类 号：R722.1[医药卫生—儿科]