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Neuroprotection and Hypothermia in Infants and Children

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Abstract:

Brain injury is the leading cause of death in pediatric ICU. Current evidence supports the use of therapeutic hypothermia (TH) in unconscious patients after out-of-hospital cardiac arrest when the initial heart rhythm was ventricular fibrillation. TH has been proved to be also beneficial in term neonates after hypoxic–ischemic encephalopathy (HIE) and in children with traumatic brain injury (TBI). Recent reports have also investigated TH for the treatment of superrefractory status epilepticus. The clinical application of TH is based on the possibility to inhibit or lessen a myriad of destructive processes (including excitotoxicty, neuroinflammation, apoptosis, free radical production, seizure activity, blood– brain barrier disruption, blood vessel leakage) that take place in the injured tissue following ischemia–reperfusion. TH may also represent a useful tool when conventional therapy fails to achieve an effective control of elevated intracranial pressure. This review is aimed to provide an update of the available literature concerning this intriguing topic.

Keywords: Asphyxia; brain injury; cardiac arrest; child; epilepsy; hypothermia; intracranial pressure; neonate; superrefractory status epilepticus; ventricular fibrillation

Document Type: Research Article

DOI: https://doi.org/10.2174/138945012800675641

Affiliations: Neuroanestesia Pediatrica, Terapia Intensiva Pediatrica - DEA, Policlinico Universitario “A.Gemelli”, Universita Cattolica del Sacro Cuore, L.go A.Gemelli 8, 00168 Roma, Italia.

Publication date: 2012-06-01

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  • Current Drug Targets aims to cover the latest and most outstanding developments on the medicinal chemistry and pharmacology of molecular drug targets e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal will be devoted to a single timely topic, with series of in-depth reviews, written by leaders in the field, covering a range of current topics on drug targets. These issues will be organized and led by a guest editor who is a recognized expert in the overall topic. As the discovery, identification, characterisation and validation of novel human drug targets for drug discovery continues to grow; this journal will be essential reading for all pharmaceutical scientists involved in drug discovery and development.
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