Department of Pediatrics, UNC School of Medicine, The University of North Carolina at Chapel Hill, Campus Box #7596, Chapel Hill, NC, 27599-7596, USA.
Department of Pediatrics, Duke University, Durham, NC, USA.
Sci Rep. 2024 Aug 17;14(1):19082. doi: 10.1038/s41598-024-70410-w.
Therapeutic hypothermia is the standard treatment for hypoxic-ischemic encephalopathy (HIE), but despite its widespread use, the rates of mortality and neurodevelopmental impairment for moderate to severe HIE remain around 30%. Methylxanthines, such as caffeine and aminophylline, have potential neuroprotective effects in the setting of hypoxic-ischemic injury. However, data on the safety and efficacy of methylxanthines in the setting of therapeutic hypothermia for HIE are limited. This retrospective multicenter study examined in-hospital outcomes in 52 infants with HIE receiving methylxanthines and therapeutic hypothermia. The frequency of mortality and in-hospital morbidities were similar to those of infants enrolled in clinical trials undergoing therapeutic hypothermia without adjunctive therapies. Clinical trials of methylxanthines for neuroprotection in HIE are needed to determine safety and efficacy and should explore optimal dosing and timing of methylxanthine administration.
治疗性低温是缺氧缺血性脑病（HIE）的标准治疗方法，但尽管广泛应用，中重度 HIE 的死亡率和神经发育障碍率仍约为 30%。茶碱类药物，如咖啡因和氨茶碱，在缺氧缺血性损伤时具有潜在的神经保护作用。然而，关于在 HIE 治疗性低温治疗中使用茶碱类药物的安全性和疗效的数据有限。这项回顾性多中心研究检查了 52 名接受茶碱类药物和治疗性低温治疗的 HIE 婴儿的住院期间结局。死亡率和住院期间发病率与未接受辅助治疗的接受治疗性低温治疗的临床试验中纳入的婴儿相似。需要进行茶碱类药物治疗 HIE 的神经保护作用的临床试验，以确定安全性和疗效，并应探索茶碱类药物给药的最佳剂量和时间。
