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Therapies for neona...
Therapies for neonatal encephalopathy: Targeting the latent, secondary and tertiary phases of evolving brain injury
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Chakkarapani, A. A. (author)
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Aly, H. (author)
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Benders, M. (author)
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Cotten, C. M. (author)
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El-Dib, M. (author)
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Gressens, P. (author)
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- Hagberg, Henrik, 1955 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology
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Sabir, H. (author)
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Wintermark, P. (author)
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Robertson, N. J. (author)
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Newborn Brain Society, Guidelines (author)
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Publications, Committee (author)
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(creator_code:org_t)
- Elsevier BV, 2021
- 2021
- English.
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In: Seminars in Fetal and Neonatal Medicine. - : Elsevier BV. - 1744-165X. ; 26:5
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Abstract
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- In term and near-term neonates with neonatal encephalopathy, therapeutic hypothermia protocols are well established. The current focus is on how to improve outcomes further and the challenge is to find safe and complementary therapies that confer additional protection, regeneration or repair in addition to cooling. Following hypoxia-ischemia, brain injury evolves over three main phases (latent, secondary and tertiary), each with a different brain energy, perfusion, neurochemical and inflammatory milieu. While therapeutic hypothermia has targeted the latent and secondary phase, we now need therapies that cover the continuum of brain injury that spans hours, days, weeks and months after the initial event. Most agents have several therapeutic actions but can be broadly classified under a predominant action (e.g., free radical scavenging, anti-apoptotic, anti-inflammatory, neuroregeneration, and vascular effects). Promising early/secondary phase therapies include Allopurinol, Azithromycin, Exendin-4, Magnesium, Melatonin, Noble gases and Sildenafil. Tertiary phase agents include Erythropoietin, Stem cells and others. We review a selection of promising therapeutic agents on the translational pipeline and suggest a framework for neuroprotection and neurorestoration that targets the evolving injury. © 2021 Elsevier Ltd
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- Neonatal encephalopathy
- Neuroprotection
- Neurorestoration
- Therapeutic hypothermia
Publication and Content Type
- ref (subject category)
- art (subject category)
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Chakkarapani, A. ...
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Aly, H.
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Benders, M.
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Cotten, C. M.
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El-Dib, M.
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Gressens, P.
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show more...
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Hagberg, Henrik, ...
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Sabir, H.
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Wintermark, P.
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Robertson, N. J.
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Newborn Brain So ...
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Publications, Co ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Obstetrics Gynae ...
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Seminars in Feta ...
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University of Gothenburg