scholarly journals Encephalopathy in Preterm Infants: Advances in Neuroprotection With Caffeine

2021 ◽  
Vol 9 ◽  
Author(s):  
Liu Yang ◽  
Xuefei Yu ◽  
Yajun Zhang ◽  
Na Liu ◽  
Xindong Xue ◽  
...  
Keyword(s):  
Brain Injury ◽  
Preterm Infants ◽  
Calcium Ion ◽  
Aminobutyric Acid ◽  
Phosphodiesterase Inhibition ◽  
Immature Brain ◽  
Receptor Antagonism ◽  
Beneficial Effects ◽  
Neuroprotective Strategies ◽  
Time Of Administration

With the improvement in neonatal rescue technology, the survival rate of critically ill preterm infants has substantially increased; however, the incidence of brain injury and sequelae in surviving preterm infants has concomitantly increased. Although the etiology and pathogenesis of preterm brain injury, and its prevention and treatment have been investigated in recent years, powerful and effective neuroprotective strategies are lacking. Caffeine is an emerging neuroprotective drug, and its benefits have been widely recognized; however, its effects depend on the dose of caffeine administered, the neurodevelopmental stage at the time of administration, and the duration of exposure. The main mechanisms of caffeine involve adenosine receptor antagonism, phosphodiesterase inhibition, calcium ion activation, and γ-aminobutyric acid receptor antagonism. Studies have shown that there are both direct and indirect beneficial effects of caffeine on the immature brain. Accordingly, this article briefly reviews the pharmacological characteristics of caffeine, its mechanism of action in the context of encephalopathy in premature infants, and its use in the neuroprotection of encephalopathy in this patient population.

scholarly journals Rapid Cerebral Metabolic Shift during Neonatal Sepsis Is Attenuated by Enteral Colostrum Supplementation in Preterm Pigs

Metabolites ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 13 ◽  
Author(s):  
Masoumeh Alinaghi ◽  
Ping-Ping Jiang ◽  
Anders Brunse ◽  
Per Sangild ◽  
Hanne Bertram
Keyword(s):  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Neonatal Sepsis ◽  
Normal Brain ◽  
Metabolic Shift ◽  
Lung Maturation ◽  
Immature Brain ◽  
Tissue Samples ◽  
Beneficial Effects ◽  
Lactate Levels

Sepsis, the clinical manifestation of serious infection, may disturb normal brain development, especially in preterm infants with an immature brain. We hypothesized that neonatal sepsis induces systemic metabolic alterations that rapidly affect metabolic signatures in immature brain and cerebrospinal fluid (CSF). Cesarean-delivered preterm pigs systemically received 109 CFU/kg Staphylococcus epidermidis (SE) and were provided total parenteral nutrition (n = 9) or enteral supplementation with bovine colostrum (n = 10) and compared with uninfected pigs receiving parenteral nutrition (n = 7). Plasma, CSF, and brain tissue samples were collected after 24 h and analyzed by 1H NMR-based metabolomics. Both plasma and CSF metabolomes revealed SE-induced changes in metabolite levels that reflected a modified energy metabolism. Hence, increased plasma lactate, alanine, and succinate levels, as well as CSF lactate levels, were observed during SE infection (all p < 0.05, ANOVA analysis). Myo-inositol, a glucose derivative known for beneficial effects on lung maturation in preterm infants, was also increased in plasma and CSF following SE infection. Enteral colostrum supplementation attenuated the lactate accumulation in blood and CSF. Bloodstream infection in preterm newborns was found to induce a rapid metabolic shift in both plasma and CSF, which was modulated by colostrum feeding.

scholarly journals New Antioxidant Drugs for Neonatal Brain Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Maria Luisa Tataranno ◽  
Serafina Perrone ◽  
Mariangela Longini ◽  
Giuseppe Buonocore
Keyword(s):  
Oxidative Stress ◽  
Brain Injury ◽  
Postnatal Period ◽  
Limited Capacity ◽  
Neonatal Brain ◽  
Immature Brain ◽  
Beneficial Effects ◽  
Neurodevelopmental Impairment ◽  
The Brain

The brain injury concept covers a lot of heterogeneity in terms of aetiology involving multiple factors, genetic, hemodynamic, metabolic, nutritional, endocrinological, toxic, and infectious mechanisms, acting in antenatal or postnatal period. Increased vulnerability of the immature brain to oxidative stress is documented because of the limited capacity of antioxidant enzymes and the high free radicals (FRs) generation in rapidly growing tissue. FRs impair transmembrane enzyme Na+/K+-ATPase activity resulting in persistent membrane depolarization and excessive release of FR and excitatory aminoacid glutamate. Besides being neurotoxic, glutamate is also toxic to oligodendroglia, via FR effects. Neuronal cells die of oxidative stress. Excess of free iron and deficient iron/binding metabolising capacity are additional features favouring oxidative stress in newborn. Each step in the oxidative injury cascade has become a potential target for neuroprotective intervention. The administration of antioxidants for suspected or proven brain injury is still not accepted for clinical use due to uncertain beneficial effects when treatments are started after resuscitation of an asphyxiated newborn. The challenge for the future is the early identification of high-risk babies to target a safe and not toxic antioxidant therapy in combination with standard therapies to prevent brain injury and long-term neurodevelopmental impairment.

scholarly journals Sensory Stimulation in the NICU Environment: Devices, Systems, and Procedures to Protect and Stimulate Premature Babies

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 334
Author(s):  
Francesco Massimo Vitale ◽  
Gaetano Chirico ◽  
Carmen Lentini
Keyword(s):  
Music Therapy ◽  
Preterm Infants ◽  
Noise Pollution ◽  
Sensory Stimulation ◽  
Normative Values ◽  
Control Groups ◽  
Beneficial Effects ◽  
Stressful Environment ◽  
Premature Babies ◽  
Systematic Control

Prematurity deprives infants of the prenatal sensory stimulation essential to their correct development; in addition, the stressful environment of the NICU impacts negatively on their growth. The purpose of this review was to investigate the effects of NICU noise pollution on preterm infants and parents. We focused on the systems and projects used to control and modulate sounds, as well as on those special devices and innovative systems used to deliver maternal sounds and vibrations to this population. The results showed beneficial effects on the preterm infants in different areas such as physiological, autonomic, and neurobehavioral development. Although most of these studies highlight positive reactions, there is also a general acknowledgement of the current limits: small and heterogeneous groups, lack of structured variable measurements, systematic control groups, longitudinal studies, and normative values. The mother’s presence is always preferred, but the use of music therapy and the devices analyzed, although not able to replace her presence, aim to soften her absence through familiar and protective stimuli, which is a very powerful aid during the COVID-19 pandemic.

A systematic review on brain injury and altered brain development in moderate-late preterm infants

2020 ◽  
Vol 148 ◽  
pp. 105094
Author(s):  
Vivian Boswinkel ◽  
Jacqueline Nijboer-Oosterveld ◽  
Ingrid M. Nijholt ◽  
Mireille A. Edens ◽  
Susanne M. Mulder - de Tollenaer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Brain Development ◽  
Preterm Infants ◽  
Late Preterm ◽  
Late Preterm Infants

scholarly journals Beneficial effects of n -acetylcysteine on ischaemic brain injury

2000 ◽  
Vol 130 (6) ◽  
pp. 1219-1226 ◽  
Author(s):  
Salvatore Cuzzocrea ◽  
Emanuela Mazzon ◽  
Giuseppina Costantino ◽  
Ivana Serraino ◽  
Laura Dugo ◽  
...  
Keyword(s):  
Brain Injury ◽  
Beneficial Effects ◽  
Ischaemic Brain ◽  
Ischaemic Brain Injury

Transcutaneous Oxygen Tension During Nonnutritive Sucking in Preterm Infants

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 539-542
Author(s):  
Roberto Paludetto ◽  
Steven S. Robertson ◽  
Maureen Hack ◽  
Chandra R. Shivpuri ◽  
Richard J. Martin
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Preterm Infants ◽  
Oxygen Tension ◽  
Sleep State ◽  
Transcutaneous Oxygen Tension ◽  
Transcutaneous Oxygen ◽  
Beneficial Effects ◽  
Nonnutritive Sucking ◽  
Postconceptional Age

The effects of nonnutritive sucking on transcutaneous oxygen tension, heart rate, and respiratory rate were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygen tension increased during nonnutritive sucking in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. These data offer further support for the beneficial effects of nonnutritive sucking in preterm infants.

Gender differences in the developmental outcomes of children with congenital cardiac defects

2012 ◽  
Vol 22 (5) ◽  
pp. 514-519 ◽  
Author(s):  
Annette Majnemer ◽  
Catherine Limperopoulos ◽  
Michael Shevell ◽  
Charles Rohlicek ◽  
Bernard Rosenblatt ◽  
...  
Keyword(s):  
Gender Differences ◽  
Brain Injury ◽  
Functional Independence Measure ◽  
Early Brain Injury ◽  
Functional Independence ◽  
Receptive Language ◽  
Full Scale ◽  
Fine Motor ◽  
Intellectual Quotient ◽  
Neuroprotective Strategies

AbstractObjectiveThis study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.Study designA prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).ResultsThe mean scores of the boys on the WeeFIM subscales, such as self-care, mobility, cognition, were significantly lower than that of the girls. There was a trend for a greater proportion of boys to have abnormalities on neurological examination (boys 37.5 percent abnormal, girls 19.5 percent abnormal). Verbal, performance, and full scale Intellectual Quotients were 5–7 points lower in boys but did not reach significance (full scale Intellectual Quotient: boys 87.7 plus or minus 22.2; girls 93.9 plus or minus 19.3). Boys were more likely to have fine motor delays (50 percent, 82.7 plus or minus 16.5) compared with girls (28.2 percent, 87.0 plus or minus 15.8). There were no gender differences in receptive language or behavioural difficulties.ConclusionsBoys born with congenital heart disease requiring early surgical repair appear to be at enhanced risk for neuromotor impairments and activity limitations. Findings support gender differences in the pathogenesis of early brain injury following hypoxic–ischaemic insults. This has implications for neuroprotective strategies to prevent brain injury.

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