Abstract
Aims : To know the effects of recombinant human erythropoietin (rhEPO) concurrent with hypothermia (HT) on neuron-specific enolase (NSE) and S100B protein levels in cerebrospinal fluid (CSF) in newbons with hypoxia-ischemia encephalopathy (HIE) and to evaluate the presence of EPO in CSF as well as the safety of repeated low doses of rhEPO. Subjects and Methods: This prospective study enrolled 15 infants with HIE. All infants received rhEPO (NeoRecormon ® ) intravenously in the first 3 h of life, at a dose-rate of 400 IU/kg/48 h, 2 weeks concurrent with total body HT. NSE and PS100B in CSF were collected after rewarming. Magnetic resonance imaging was undertaken by a single neuroradiologist between 7 and 15 days of life in surviving infants. Developmental assessments were performed at the age of 18 months. The Bayley Scales of Infant Development was performed. Results : There were two deaths in the first 72 h of life (13.3%). Moderate to severe disability occurred in one child (6.6%). 80% survived with no neurodevelopmental handicaps at 18 months of life. NSE and PS100B values in CSF were 25.1 ± 14.23 μg/L and 9.27 ± 16.19 μg/L respectively. EPO values in CSF were 45.6 ± 12.23 mU/mL.Time to reach normal background pattern in infants with no severe disability at 18 months of age was before 48 h of life. No complications were recorded. Conclusion : EPO is an affordable cytokine with the potential neuroprotective effect that can be used in combination with HT and crosses blood brain barrier. Further research is required to define the optimum treatment.
Published Version
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