Skip to main content

Neuroprotective therapies in the NICU in term infants: present and future.

Publication ,  Journal Article
Molloy, EJ; El-Dib, M; Juul, SE; Benders, M; Gonzalez, F; Bearer, C; Wu, YW; Robertson, NJ; Hurley, T; Branagan, A; Michael Cotten, C; Tan, S ...
Published in: Pediatr Res
June 2023

Outcomes of neonatal encephalopathy (NE) have improved since the widespread implementation of therapeutic hypothermia (TH) in high-resource settings. While TH for NE in term and near-term infants has proven beneficial, 30-50% of infants with moderate-to-severe NE treated with TH still suffer death or significant impairments. There is therefore a critical need to find additional pharmacological and non-pharmacological interventions that improve the outcomes for these children. There are many potential candidates; however, it is unclear whether these interventions have additional benefits when used with TH. Although primary and delayed (secondary) brain injury starting in the latent phase after HI are major contributors to neurodisability, the very late evolving effects of tertiary brain injury likely require different interventions targeting neurorestoration. Clinical trials of seizure management and neuroprotection bundles are needed, in addition to current trials combining erythropoietin, stem cells, and melatonin with TH. IMPACT: The widespread use of therapeutic hypothermia (TH) in the treatment of neonatal encephalopathy (NE) has reduced the associated morbidity and mortality. However, 30-50% of infants with moderate-to-severe NE treated with TH still suffer death or significant impairments. This review details the pathophysiology of NE along with the evidence for the use of TH and other beneficial neuroprotective strategies used in term infants. We also discuss treatment strategies undergoing evaluation at present as potential adjuvant treatments to TH in NE.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pediatr Res

DOI

EISSN

1530-0447

Publication Date

June 2023

Volume

93

Issue

7

Start / End Page

1819 / 1827

Location

United States

Related Subject Headings

  • Pediatrics
  • Neuroprotective Agents
  • Neuroprotection
  • Intensive Care Units, Neonatal
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Infant
  • Hypoxia-Ischemia, Brain
  • Hypothermia, Induced
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Molloy, E. J., El-Dib, M., Juul, S. E., Benders, M., Gonzalez, F., Bearer, C., … Newborn Brain Society Guidelines and Publications Committee, . (2023). Neuroprotective therapies in the NICU in term infants: present and future. Pediatr Res, 93(7), 1819–1827. https://doi.org/10.1038/s41390-022-02295-2
Molloy, Eleanor J., Mohamed El-Dib, Sandra E. Juul, Manon Benders, Fernando Gonzalez, Cynthia Bearer, Yvonne W. Wu, et al. “Neuroprotective therapies in the NICU in term infants: present and future.Pediatr Res 93, no. 7 (June 2023): 1819–27. https://doi.org/10.1038/s41390-022-02295-2.
Molloy EJ, El-Dib M, Juul SE, Benders M, Gonzalez F, Bearer C, et al. Neuroprotective therapies in the NICU in term infants: present and future. Pediatr Res. 2023 Jun;93(7):1819–27.
Molloy, Eleanor J., et al. “Neuroprotective therapies in the NICU in term infants: present and future.Pediatr Res, vol. 93, no. 7, June 2023, pp. 1819–27. Pubmed, doi:10.1038/s41390-022-02295-2.
Molloy EJ, El-Dib M, Juul SE, Benders M, Gonzalez F, Bearer C, Wu YW, Robertson NJ, Hurley T, Branagan A, Michael Cotten C, Tan S, Laptook A, Austin T, Mohammad K, Rogers E, Luyt K, Bonifacio S, Soul JS, Gunn AJ, Newborn Brain Society Guidelines and Publications Committee. Neuroprotective therapies in the NICU in term infants: present and future. Pediatr Res. 2023 Jun;93(7):1819–1827.

Published In

Pediatr Res

DOI

EISSN

1530-0447

Publication Date

June 2023

Volume

93

Issue

7

Start / End Page

1819 / 1827

Location

United States

Related Subject Headings

  • Pediatrics
  • Neuroprotective Agents
  • Neuroprotection
  • Intensive Care Units, Neonatal
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Infant
  • Hypoxia-Ischemia, Brain
  • Hypothermia, Induced
  • Humans