Cited by 58Neonatal and fetal brain pathologyThermal Regulation in MedicineNeuroscience of respiration and sleep

Drugs for neuroprotection after birth asphyxia: Pharmacologic adjuncts to hypothermia

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Bel, Frank van, Groenendaal, Floris·2016·Seminars in Perinatology

Abstract

An adverse outcome is still encountered in 45% of full-term neonates with perinatal asphyxia who are treated with moderate hypothermia. At present pharmacologic therapies are developed to be added to hypothermia. In the present article, these potential neuroprotective interventions are described based on the molecular pathways set in motion during fetal hypoxia and following reoxygenation and reperfusion after birth. These pathways include excessive production of excitotoxins with subsequent over-stimulation of NMDA receptors and calcium influx in neuronal cells, excessive production of reactive oxygen and nitrogen species, activation of inflammation leading to inappropriate apoptosis, and loss of neurotrophic factors. Possibilities for pharmacologic combination therapy, where each drug will be administered based on the optimal point of time in the cascade of destructive molecular reactions, may further reduce brain damage due to perinatal asphyxia.

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Crossref · 10.1053/j.semperi.2015.12.003

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Authors
Bel, F. V., & Groenendaal, F.
Affiliations
University Medical Center Utrecht (NL)
Corresponding author
Bel, Frank van
Venue
Seminars in Perinatology
Publisher
Elsevier BV
Published
2016-04
Volume
40
Issue
3
Pages
152-159
ISSN
0146-0005 (ISSN-L)
OpenAlex
W2285862104
Cited by
58
References
102
Citations by year
2026: 2 · 2025: 3 · 2024: 15 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 1
FWCI
0.77
Type
journal article
Language
en
Open access
Locations
  • Seminars in Perinatology (publishedVersion)
  • PubMed (publishedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords
perinatal asphyxia, neuroprotection, therapeutic hypothermia, combination therapy, excitotoxicity, NMDA receptor, calcium influx, reactive oxygen species, reactive nitrogen species, neuroinflammation, apoptosis, neurotrophic factors, ischemia-reperfusion injury, term infants, brain damage
MeSH terms
Neuroprotection, Asphyxia Neonatorum, Humans, Hypothermia, Induced, Infant, Newborn, Metabolism, Neuroprotective Agents, Hypoxia-Ischemia, Brain, Term Birth

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