Tolaymat Youness, Doré Sylvain, Griffin Hudson W, Shih Susana, Edwards Mary E, Weiss Michael D
Department of Pediatrics, University of Florida, Gainesville, FL, United States.
Departments of Neurology, Psychiatry, Pharmaceuticals and Neuroscience, University of Florida, Gainesville, FL, United States.
Front Pediatr. 2020 Jan 27;7:558. doi: 10.3389/fped.2019.00558. eCollection 2019.
Hypoxic-ischemic encephalopathy (HIE) is a significant cause of morbidity and mortality in neonates. The incidence of HIE is 1-8 per 1,000 live births in developed countries. Whole-body hypothermia reduces the risk of disability or death, but 7 infants needed to be treated to prevent death or major neurodevelopmental disability. Inhalational gases may be promising synergistic agents due to their rapid onset and easy titratability. To review current data on different inhaled gases with neuroprotective properties that may serve as adjunct therapies to hypothermia. Literature review was performed using the PubMed database, google scholar, and ClinicalTrials.Gov. Results focused on articles published from January 1, 2005, through December 31, 2017. Articles published earlier than 2005 were included when appropriate for historical perspective. Our review emphasized preclinical and clinical studies relevant to the use of inhaled agents for neuroprotection. Based on the relevance to our topic, 111 articles were selected pertaining to the incidence of HIE, pathophysiology of HIE, therapeutic hypothermia, and emerging therapies for hypoxic-ischemic encephalopathy in preclinical and clinical settings. Supplemental tables summarizes highly relevant 49 publications that were included in this review. The selected publications emphasize the emergence of promising inhaled gases that may improve neurologic survival and alleviate neurodevelopmental disability when combined with therapeutic hypothermia in the future. Many inhaled agents have neuroprotective properties and could serve as an adjunct therapy to whole-body hypothermia. Inhaled agents are ideal due to their easy administration, titrability, and rapid onset and offset.
缺氧缺血性脑病（HIE）是新生儿发病和死亡的重要原因。在发达国家，HIE的发病率为每1000例活产中有1 - 8例。全身低温可降低残疾或死亡风险，但需要治疗7名婴儿才能预防死亡或严重神经发育障碍。吸入性气体因其起效迅速且易于滴定，可能是有前景的协同治疗药物。旨在综述目前关于具有神经保护特性的不同吸入性气体的数据，这些气体可作为低温治疗的辅助疗法。使用PubMed数据库、谷歌学术和ClinicalTrials.Gov进行文献综述。结果聚焦于2005年1月1日至2017年12月31日发表的文章。为了获得历史视角，2005年之前发表的文章在适当情况下也被纳入。我们的综述强调了与使用吸入性药物进行神经保护相关的临床前和临床研究。根据与我们主题的相关性，选择了111篇关于HIE发病率、HIE病理生理学、治疗性低温以及临床前和临床环境中缺氧缺血性脑病新兴疗法的文章。补充表格总结了本综述中纳入的49篇高度相关的出版物。所选出版物强调了有前景的吸入性气体的出现，这些气体未来与治疗性低温联合使用时可能改善神经学预后并减轻神经发育障碍。许多吸入性药物具有神经保护特性，可作为全身低温的辅助疗法。吸入性药物因其易于给药、可滴定性以及起效和消退迅速而非常理想。
