Avtor/Urednik		Wood, Thomas; Osredkar, Damjan; Puchades, Maja; Maes, Elke; Falck, Mari; Flatebø, Torun; Walloe, Lars; Sabir, Hemmen; Thoresen, Marianne
Naslov		Treatment temperature and insult severity influence the neuroprotective effects of therapeutic hypothermia
Tip		članek
Vol. in št.		Letnik 6, št. art. no. 23430
Leto izdaje		2016
Obseg		str. 1-12
ISSN		2045-2322 - Scientific reports
Jezik		eng
Abstrakt		Therapeutic hypothermia (HT) is standard care for moderate and severe neonatal hypoxic-ischaemic encephalopathy (HIE), the leading cause of permanent brain injury in term newborns. However, the optimal temperature for HT is still unknown, and few preclinical studies have compared multiple HT treatment temperatures. Additionally, HT may not benefit infants with severe encephalopathy. In a neonatal rat model of unilateral hypoxia-ischaemia (HI), the effect of five different HT temperatures was investigated after either moderate or severe injury. At postnatal-day seven, rat pups underwent moderate or severe HI followed by 5h at normothermia (37⁰C), or one of five HT temperatures: 33.5⁰C, 32⁰C, 30⁰C, 26⁰C, and 18⁰C. One week after treatment, neuropathological analysis of hemispheric and hippocampal area loss, and CA1 hippocampal pyramidal neuron count, was performed. After moderate injury, a significant reduction in hemispheric and hippocampal loss on the injured side, and preservation of CA1 pyramidal neurons, was seen in the 33.5⁰C, 32⁰C, and 30⁰C groups. Cooling below 33.5⁰C did not provide additional neuroprotection. Regardless of treatment temperature, HT was not neuroprotective in the severe HI model. Based on these findings, and previous experience translating preclinical studies into clinical application, we propose that milder cooling should be considered for future clinical trials.
Proste vsebinske oznake		terapevtska hipotermija novorojenček encefalopatija therapeutic hypothermia neonatal encephalopathy