Treatments and therapeutic protocols for the recovery of anasphyxiated new-born: Areview ofpre-clinical and clinical studies inhuman neonates and indifferent animal models.

Abstract

The objective ofthis review is toascertain the advantages and disadvantages ofseveral treatments and therapeutic protocols that have been used for the prevention and treatment ofperinatal asphyxia inhuman neonates and indifferent animal models. Perinatal asphyxia isone ofthe main causes ofmortality worldwide and isanimportant factor intriggering physio-metabolic disorders that result inserious neurological consequences and learning disorders not only inhuman foetuses and neonates, but also inanimals. Inrecent years, the search for new pharmacological protocols toprevent and reverse physio-metabolic disorders and brain damage derived from perinatal asphyxia has been and continues to bethe subject ofintense research. Currently, within these pharmacological protocols, therapeutic strategies have been evaluated that use respiratory and hormonal stimulants, aswell ashypothermic therapies incombination with other putative neuroprotective agents. Similarly, energy supplements have been evaluated with the objective ofpreventing perinatal asphyxia and treating new-borns with this condition, and todecrease the incidence ofneonatal and foetal deaths associated with it. However, despite these promising advances, this pathology has persisted, since the administration ofthese therapies inlow doses may not exert aneuroprotective effect or, inhigh doses, can trigger adverse effects (such asreduced cardiac contractility, reduced cerebral blood flow, poor perfusion, sympathetic and neuroendocrine stimulation, and increased blood viscosity) inhuman foetuses and neonates aswell as indifferent animal models (rats, piglets, sheep and rabbits). Therefore, it isimportant todetermine the minimum effective dose with which these therapies exert aneuroprotective effect, aswell asthemode ofadministration, theduration oftherapy, etc. Therefore, until apowerful strategy isfound toimprove the consequences ofsuffocation, this topic will continue to bethe subject ofintensive research inthe future.