Neonatal Encephalopathy: Update on Therapeutic Hypothermia and Other Novel Therapeutics

Clin Perinatol. 2016 Sep;43(3):485-500. doi: 10.1016/j.clp.2016.04.007. Epub 2016 Jun 22.

Abstract

Neonatal encephalopathy (NE) is a major cause of neonatal mortality and morbidity. Therapeutic hypothermia (TH) is standard treatment for newborns at 36 weeks of gestation or greater with intrapartum hypoxia-related NE. Term and late preterm infants with moderate to severe encephalopathy show improved survival and neurodevelopmental outcomes at 18 months of age after TH. TH can increase survival without increasing major disability, rates of an IQ less than 70, or cerebral palsy. Neonates with severe NE remain at risk of death or severe neurodevelopmental impairment. This review discusses the evidence supporting TH for term or near term neonates with NE.

Keywords: Dexmedetomidine; Erythropoietin; Melatonin; N-acetylcysteine; Neurodevelopment; Stem cells; Umbilical cord milking; Xenon.

Publication types

  • Review

MeSH terms

  • Anesthetics, Inhalation / therapeutic use
  • Biotin / analogs & derivatives
  • Biotin / therapeutic use
  • Central Nervous System Depressants / therapeutic use
  • Cerebral Palsy
  • Constriction
  • Erythropoietin / therapeutic use
  • Humans
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Intellectual Disability
  • Melatonin / therapeutic use
  • Stem Cell Transplantation
  • Survival Rate
  • Umbilical Cord
  • Xenon / therapeutic use

Substances

  • Anesthetics, Inhalation
  • Central Nervous System Depressants
  • Erythropoietin
  • Xenon
  • Biotin
  • 2-iminobiotin
  • Melatonin