Gp. Giacoia, ASPHYXIAL BRAIN-DAMAGE IN THE NEWBORN - NEW INSIGHTS INTO PATHOPHYSIOLOGY AND POSSIBLE PHARMACOLOGICAL INTERVENTIONS, Southern medical journal, 86(6), 1993, pp. 676-682
New insights into the pathophysiology of the hypoxic-ischemic insult h
ave opened the possibility of pharmacologic intervention in neonatal h
ypoxic-ischemic encephalopathy. It is now known that many neurons surv
ive a hypoxic-ischemic insult but remain dysfunctional for hours, with
profound alterations in cell function. A cascade of biochemical alter
ations occurs as a consequence of cellular ionic shifts, energy deplet
ion, degradation of cell membrane phospholipids, and increased release
of neurotransmitters. In addition, there are alterations in the metab
olism of arachidonic acid and prostanoids and an excessive production
of oxygen free radicals. The new therapeutic modalities are aimed at p
reventing or arresting the biochemical changes that occur in the perio
d after hypoxia-ischemia. This review details the biochemical alterati
ons associated with neonatal hypoxic-ischemic encephalopathy and discu
sses the possible use in newborns of pharmacologic agents currently un
dergoing extensive investigations in experimental animals and adult hu
mans.