Background Hypothermia (HT) within the first six hours of life provides neuroprotection in newborns with hypoxic ischaemic encephalopathy (HIE). Erythropoietin (EPO) has been found to enhance erythropoiesis and exert anti-inflammatory, immunomodulatory, antiapoptotic and neuroprotective effects.
Aim To evaluate the efficacy and safety of EPO therapy in neonates with HIE.
Methods 15 newborns with HIE displaying no congenital malformations of life-threatening pathologies, received treatment with HT(n = 3), EPO (n = 3) or HT+EPO (n = 9). Once informed consent had been obtained, rhEPO was iniciated subcutaneously in the first 24 h of life at a dose rate of 400 UI/k/q48h/2weeks.
Results Baseline clinical data for the three study group are shown in figure1. No intergroup differences were recorded for incidence of clinical and electrical seizures over the first 24 h. Neurological examination at 12 months revealed a reduction in death rates and in severe disability rates (p = 0,021). Brain damage biomarkers level were lower. No complications were recorded following treatment with rhEPO. Data were analysed using the ChiSquare test for qualitative variables and the kruskal-Wallis test for quantitative variables; the level of significance was set at p < 0.05.
Conclusions Hypothermia has been demonstrated the only therapeutic option against brain damage in newborns with HIE but rhEPO is an effective, safe, affordable cytokine with potential neuroprotective effects. It could be used in combination with HT for treating HIE. Further research are required to define the optimum treatment in these patients.
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