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41 - Extended management following resuscitation

from Section 5 - Management of the depressed or neurologically dysfunctional neonate

Published online by Cambridge University Press:  12 January 2010

David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

After the initial resuscitation of an encephalopathic infant, the extended management of the patient becomes critical in order to prevent as much secondary damage as possible. There are many different management protocols that are acceptable, and it is not the intent of this chapter to review all of them used for the various conditions encountered in neonatal intensive care. Rather, we focus on the early transitional period following birth and resuscitation, during which the condition of the depressed infant can be substantially improved by expert care.

As noted in Chapters 2 and 42, the encephalopathic period involves a continuum of biologic events associated with secondary energy failure lasting up to 48–72 hours after the initial insult. These include the reperfusion period with the elaboration of oxygen free radicals and various cytokines as well as necrosis and apoptosis that then ensue. It is imperative that the extended management of these infants be carried out in an optimal fashion at a center that can provide hypothermia or other novel neuroprotective interventions that may be developed.

Unfortunately, the windows of opportunity may be short and variable depending upon the nature of the intervention, and could change as further research informs practice. Thus there is an obligation for the practitioner to be well informed about progress in the standard of care and to stay current with respect to neuroprotective strategies. Various neuroprotective mechanisms after hypoxic–ischemic injury are discussed in detail in Chapter 42.

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Publisher: Cambridge University Press
Print publication year: 2009

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References

Benitz, WE, Frankel, LR, Stevenson, DK. The pharmacology of neonatal resuscitation and cardiopulmonary intensive care. Part II: extended intensive care. West J Med 1986; 145: 47–51.Google ScholarPubMed
Stevenson, DK, Benitz, WE. A practical approach to diagnosis and immediate care of the cyanotic neonate: stabilization and preparation for transfer to level III nursery. Clin Pediatr 1987; 26: 325–31.CrossRefGoogle ScholarPubMed
Bruce, DA. Effects of hyperventilation on cerebral blood flow and metabolism. Clin Perinatol 1984; 11: 673–80.CrossRefGoogle ScholarPubMed
Walsh-Sukys, MC, Tyson, JE, Wright, LL, et al. Persistent pulmonary hypertension of the newborn in the era before nitric oxide: practice variation and outcomes. Pediatrics 2000; 105: 14–20.CrossRefGoogle ScholarPubMed
Kusuda, S, Shishida, N, Miyagi, N, et al. Cerebral blood flow during treatment for pulmonary hypertension. Arch Dis Child Fetal Neonatal Ed 1999; 80: F30–3.CrossRefGoogle ScholarPubMed
Gleason, CA, Short, BL, Jones, MD. Cerebral blood flow and metabolism during and after prolonged hypocapnia in newborn lambs. J Pediatr 1989; 115: 309–14.CrossRefGoogle ScholarPubMed
Liem, KD, Hopman, JC, Oeseburg, B, et al. Cerebral oxygenation and hemodynamics during induction of extracorporeal membrane oxygenation as investigated by near infrared spectrophotometry. Pediatrics 1995; 95: 555–61.Google ScholarPubMed
Toft, PB, Leth, H, Lou, HC, et al. Local vascular CO2 reactivity in the infant brain assessed by functional MRI. Pediatr Radiol 1995; 25: 420–4.CrossRefGoogle ScholarPubMed
Bifano, EM, Pfannenstiel, A. Duration of hyperventilation and outcome in infants with persistent pulmonary hypertension. Pediatrics 1988; 81: 657–61.Google ScholarPubMed
Hendricks-Munoz, KD, Walton, JP. Hearing loss in infants with persistent fetal circulation. Pediatrics 1988; 81: 650–6.Google ScholarPubMed
Leavitt, AM, Watchko, JF, Bennett, FC, et al. Neurodevelopmental outcome following persistent pulmonary hypertension of the neonate. J Perinatol 1987; 7: 288–91.Google ScholarPubMed
Walsh-Sukys, MC, Cornell, DJ, Houston, LN, et al. Treatment of persistent pulmonary hypertension of the newborn without hyperventilation: an assessment of diffusion of innovation. Pediatrics 1994; 94: 303–6.Google ScholarPubMed
Wung, JT, James, LS, Kilchevsky, E, et al. Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation. Pediatrics 1985; 76: 488–94.Google ScholarPubMed
Clark, RH, Yoder, BA, Sell, MS. Prospective, randomized comparison of high-frequency oscillation and conventional ventilation in candidates for extracorporeal membrane oxygenation. J Pediatr 1994; 124: 447–54.CrossRefGoogle ScholarPubMed
Baumgart, S, Hirschl, RB, Butler, SZ, et al. Diagnosis-related criteria in the consideration of extracorporeal membrane oxygenation in neonates previously treated with high-frequency jet ventilation. Pediatrics 1992; 89: 491–4.Google ScholarPubMed
deLemos, R, Yoder, B, McCurnin, D, et al. The use of high-frequency oscillatory ventilation (HFOV) and extracorporeal membrane oxygenation (ECMO) in the management of the term/near term infant with respiratory failure. Early Hum Dev 1992; 29: 299–303.CrossRefGoogle ScholarPubMed
Bhuta, T, Henderson-Smart, DJ. Rescue high frequency oscillatory ventilation versus conventional ventilation for pulmonary dysfunction in preterm infants. Cochrane Database Syst Rev 2000; (2): CD000438.Google ScholarPubMed
Hintz, SR, Suttner, DM, Sheehan, AM, et al. Decreased use of neonatal extracorporeal membrane oxygenation (ECMO): how new treatment modalities have affected ECMO utilization. Pediatrics 2000; 106: 1339–43.CrossRefGoogle ScholarPubMed
Crone, RK, Favorito, J. The effects of pancuronium bromide on infants with hyaline membrane disease. J Pediatr 1980; 97: 991–3.CrossRefGoogle ScholarPubMed
Goudsouzian, NG, Liu, LM, Savarese, JJ. Metocurine in infants and children: neuromuscular and clinical effects. Anesthesiology 1978; 49: 266–9.CrossRefGoogle ScholarPubMed
Jobe, AH. Pulmonary surfactant therapy. N Engl J Med 1993; 328: 861–8.Google ScholarPubMed
Kendig, JW, Ryan, RM, Sinkin, RA, et al. Comparison of two strategies for surfactant prophylaxis in very premature infants: a multicenter randomized trial. Pediatrics 1998; 101: 1006–12.CrossRefGoogle ScholarPubMed
Soll, RF. Synthetic surfactant for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev 2000; (2): CD001149.Google ScholarPubMed
Bancalari, E, del Moral, T. Bronchopulmonary dysplasia and surfactant. Biol Neonate 2001; 80 Suppl 1: 7–13.CrossRefGoogle ScholarPubMed
Greenough, A. Expanded use of surfactant replacement therapy. Eur J Pediatr 2000; 159: 635–40.CrossRefGoogle ScholarPubMed
Lotze, A, Mitchell, BR, Bulas, DI, et al. Multicenter study of surfactant (beractant) use in the treatment of term infants with severe respiratory failure. Survanta in Term Infants Study Group. J Pediatr 1998; 132: 40–7.CrossRefGoogle ScholarPubMed
,The Neonatal Inhaled Nitric Oxide Study Group (NINOS). Inhaled nitric oxide in full-term and nearly full-term infants with hypoxic respiratory failure. N Engl J Med 1997; 336: 597–604.
,The Neonatal Inhaled Nitric Oxide Study Group (NINOS). Inhaled nitric oxide and hypoxic respiratory failure in infants with congenital diaphragmatic hernia. Pediatrics 1997; 99: 838–45.
Breitweser, JA, Meyer, RA, Sperling, MA, et al. Cardiac septal hypertrophy in hyperinsulinemic infants. J Pediatr 1980; 96: 535–9.CrossRefGoogle ScholarPubMed
Seri, I. Systemic and pulmonary effects of vasopressors and inotropes in the neonate. Biol Neonate 2006; 89: 340–2.CrossRefGoogle ScholarPubMed
Zaritsky, A, Chernow, B. Use of catecholamines in pediatrics. J Pediatr 1984; 105: 341–50.CrossRefGoogle Scholar
Friedman, WF, George, BL. Treatment of congestive heart failure by altering loading conditions of the heart. J Pediatr 1985; 106: 697–706.CrossRefGoogle Scholar
Bard, H. Hemoglobin synthesis and metabolism during the neonatal period. In Christensen, RD, ed., Hematologic Problems of the Neonate. Philadelphia, PA: Saunders, 2000: 374–7.Google Scholar
Yeh, TF, Shibli, A, Leu, ST, et al. Early furosemide therapy in premature infants (less than or equal to 2000 gm) with respiratory distress syndrome: a randomized controlled trial. J Pediatr 1984; 105: 603–9.CrossRefGoogle ScholarPubMed
Overmeire, B, Smets, K, Lecoutere, D, et al. A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. N Engl J Med 2000; 343: 674–81.CrossRefGoogle ScholarPubMed
Fowlie, PW. Intravenous indomethacin for preventing mortality and morbidity in very low birth weight infants. Cochrane Database Syst Rev 2000; (3): CD000174.Google ScholarPubMed
Ment, LR, Vohr, B, Allan, W, et al. Outcome of children in the indomethacin intraventricular hemorrhage prevention trial. Pediatrics 2000; 105: 485–91.CrossRefGoogle ScholarPubMed
Ment, LR, Vohr, BR, Makuch, RW, et al. Prevention of intraventricular hemorrhage by indomethacin in male preterm infants. J Pediatr 2004; 145: 832–4.CrossRefGoogle ScholarPubMed
Clyman, RI. Recommendations for the postnatal use of indomethacin: an analysis of four separate strategies. J Pediatr 1996; 128: 601–7.CrossRefGoogle Scholar
Cools, F, Offringa, M. Meta-analysis of elective high frequency ventilation in preterm infants with respiratory distress syndrome. Arch Dis Child Fetal Neonatal Ed 1999; 80: F15–20.CrossRefGoogle ScholarPubMed
Henderson-Smart, DJ, Bhuta, T, Cools, F, et al. Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants. Cochrane Database Syst Rev 2000; (2): CD000104.Google ScholarPubMed
Meurs, KP, Wright, LL, Ehrenkranz, RA, et al. Inhaled nitric oxide for premature infants with severe respiratory failure. N Engl J Med 2005; 353: 13–22.CrossRefGoogle ScholarPubMed
Heymann, MA. Pharmacologic use of prostaglandin E1 in infant with congenital heart disease. Am Heart J 1981; 101: 837–43.CrossRefGoogle ScholarPubMed
Brann, AW, Myers, RE. Central nervous system findings in the newborn monkey following severe in utero partial asphyxia. Neurology 1975; 25: 327–38.CrossRefGoogle ScholarPubMed
Myers, RE. Two patterns of perinatal brain damage and their conditions of occurrence. Am J Obstet Gynecol 1972; 112: 246–76.CrossRefGoogle Scholar
Myers, RE. Experimental models of perinatal brain damage: relevance to human pathology. In Gluck, L, ed., Intrauterine Asphyxia and the Developing Fetal Brain. Chicago, IL: Year-Book, 1977: 37–97.Google Scholar
Mujsce, DJ, Christensen, MA, Vannucci, RC. Cerebral blood flow and edema in perinatal hypoxic–ischemic brain damage. Pediatr Res 1990; 27: 450–3.CrossRefGoogle ScholarPubMed
Young, RS, Yagel, SK. Cerebral physiological and metabolic effects of hyperventilation in the neonatal dog. Ann Neurol 1984; 16: 337–42.CrossRefGoogle ScholarPubMed
Volpe, JJ. Hypoxic–ischemic encephalopathy. In Volpe, JJ, ed., Neurology of the Newborn. Philadelphia, PA: Saunders, 2001: 217–394.Google Scholar
Lupton, BA, Hill, A, Roland, EH, et al. Brain swelling in the asphyxiated term newborn: pathogenesis and outcome. Pediatrics 1988; 82: 139–46.Google ScholarPubMed
Hill, A. Current concepts of hypoxic–ischemic cerebral injury in the term newborn. Pediatr Neurol 1991; 7: 317–25.CrossRefGoogle ScholarPubMed
Levene, MI, Evans, DH. Continuous measurement of subarachnoid pressure in the severely asphyxiated newborn. Arch Dis Child 1983; 58: 1013–15.CrossRefGoogle ScholarPubMed
Levene, MI. Management and outcome of birth asphyxia. In Levene, MI, Lilforde, RJ, eds., Fetal and Neonatal Neurology and Neurosurgery. Edinburgh: Churchill Livingstone, 1995: 427–42.Google Scholar
Levene, MI, Evans, DH, Forde, A, et al. Value of intracranial pressure monitoring of asphyxiated newborn infants. Dev Med Child Neurol 1987; 29: 311–19.CrossRefGoogle ScholarPubMed
Rosenberg, AA, Jones, MD, Traystman, RJ, et al. Response of cerebral blood flow to changes in PCO2 in fetal, newborn, and adult sheep. Am J Physiol 1982; 242: H862–6.Google ScholarPubMed
Bernbaum, JC, Russell, P, Sheridan, PH, et al. Long-term follow-up of newborns with persistent pulmonary hypertension. Crit Care Med 1984; 12: 579–83.CrossRefGoogle ScholarPubMed
Wiswell, TE, Graziani, LJ, Kornhauser, MS, et al. Effects of hypocarbia on the development of cystic periventricular leukomalacia in premature infants treated with high-frequency jet ventilation. Pediatrics 1996; 98: 918–24.Google ScholarPubMed
Dammann, O, Allred, EN, Kuban, KC, et al. Hypocarbia during the first 24 postnatal hours and white matter echolucencies in newborns ≤ 28 weeks gestation. Pediatr Res 2001; 49: 388–93.CrossRefGoogle ScholarPubMed
Vannucci, RC, Towfighi, J, Heitjan, DF, et al. Carbon dioxide protects the perinatal brain from hypoxic–ischemic damage: an experimental study in the immature rat. Pediatrics 1995; 95: 868–74.Google ScholarPubMed
Vannucci, RC, Towfighi, J, Brucklacher, RM, et al. Effect of extreme hypercapnia on hypoxic–ischemic brain damage in the immature rat. Pediatr Res 2001; 49: 799–803.CrossRefGoogle ScholarPubMed
Cooper, PR, Moody, S, Clark, WK, et al. Dexamethasone and severe head injury: a prospective double-blind study. J Neurosurg 1979; 51: 307–16.CrossRefGoogle ScholarPubMed
Dearden, NM, Gibson, JS, McDowall, DG, et al. Effect of high-dose dexamethasone on outcome from severe head injury. J Neurosurg 1986; 64: 81–8.CrossRefGoogle ScholarPubMed
Lee, MC, Mastri, AR, Waltz, AG, et al. Ineffectiveness of dexamethasone for treatment of experimental cerebral infarction. Stroke 1974; 5: 216–18.CrossRefGoogle ScholarPubMed
Svenningsen, NW, Blennow, G, Lindroth, M, et al. Brain-orientated intensive care treatment in severe neonatal asphyxia: effects of phenobarbitone protection. Arch Dis Child 1982; 57: 176–83.CrossRefGoogle ScholarPubMed
Levene, MI, Evans, DH. Medical management of raised intracranial pressure after severe birth asphyxia. Arch Dis Child 1985; 60: 12–16.CrossRefGoogle ScholarPubMed
Barks, JD, Post, M, Tuor, UI. Dexamethasone prevents hypoxic–ischemic brain damage in the neonatal rat. Pediatr Res 1991; 29: 558–63.CrossRefGoogle ScholarPubMed
Tuor, UI, Simone, CS, Barks, JD, et al. Dexamethasone prevents cerebral infarction without affecting cerebral blood flow in neonatal rats. Stroke 1993; 24: 452–7.CrossRefGoogle ScholarPubMed
,National Institutes of Health Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation of Perinatal Outcomes. Effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1994; 273: 413–8.
Adhikari, M, Moodley, M, Desai, PK. Mannitol in neonatal cerebral oedema. Brain Dev 1990; 12: 349–51.CrossRefGoogle ScholarPubMed
Marchal, C, Costagliolu, P, Leaveau, P, et al. Treatment de la souffrance cérébrale néonatale d'orisivie anoxique par le mannitol. Rev Pediatr 1974; 9: 581–9.Google Scholar
Goldberg, RN, Moscoso, P, Bauer, CR, et al. Use of barbiturate therapy in severe perinatal asphyxia: a randomized controlled trial. J Pediatr 1986; 109: 851–6.CrossRefGoogle ScholarPubMed
,Brain Resuscitation Clinical Trial I Study Group. Randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. N Engl J Med 1986; 314: 397–403.
Hall, RT, Hall, FK, Daily, DK. High-dose phenobarbital therapy in term newborn infants with severe perinatal asphyxia: a randomized, prospective study with three-year follow-up. J Pediatr 1998; 132: 345–8.CrossRefGoogle ScholarPubMed
Evans, DJ, Levene, MI, Tsakmakis, M. Anticonvulsants for preventing mortality and morbidity in full term newborns with perinatal asphyxia. Cochrane Database Syst Rev 2007; (3): CD001240.Google ScholarPubMed
Giacoia, GP. Asphyxial brain damage in the newborn: new insights into pathophysiology and possible pharmacologic interventions. South Med J 1993; 86: 676–82.CrossRefGoogle ScholarPubMed
Muir, KW, Lees, KR. Clinical experience with excitatory amino acid antagonist drugs. Stroke 1995; 26: 503–13.CrossRefGoogle ScholarPubMed
Levene, M. Role of excitatory amino acid antagonists in the management of birth asphyxia. Biol Neonate 1992; 62: 248–51.CrossRefGoogle ScholarPubMed
Steinberg, GK, Bell, TE, Yenari, MA. Dose escalation safety and tolerance study of the N-methyl-d-aspartate antagonist dextromethorphan in neurosurgery patients. J Neurosurg 1996; 84: 860–6.CrossRefGoogle ScholarPubMed
Davis, SM, Lees, KR, Albers, GW, et al. Selfotel in acute ischemic stroke: possible neurotoxic effects of an NMDA antagonist. Stroke 2000; 31: 347–54.CrossRefGoogle ScholarPubMed
Parikka, H, Toivonen, L, Naukkarinen, V, et al. Decreases by magnesium of QT dispersion and ventricular arrhythmias in patients with acute myocardial infarction. Eur Heart J 1999; 20: 111–20.CrossRefGoogle ScholarPubMed
Lampl, Y, Gilad, R, Geva, D, et al. Intravenous administration of magnesium sulfate in acute stroke: a randomized double-blind study. Clin Neuropharmacol 2001; 24: 11–15.CrossRefGoogle ScholarPubMed
Lucas, MJ, Leveno, KJ, Cunningham, FG. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. N Engl J Med 1995; 333: 201–5.CrossRefGoogle ScholarPubMed
McDonald, JW, Silverstein, FS, Johnston, MV. Magnesium reduces N-methyl-d-aspartate (NMDA)-mediated brain injury in perinatal rats. Neurosci Lett 1990; 109: 234–8.CrossRefGoogle ScholarPubMed
Marret, S, Gressens, P, Gadisseux, JF, et al. Prevention by magnesium of excitotoxic neuronal death in the developing brain: an animal model for clinical intervention studies. Dev Med Child Neurol 1995; 37: 473–84.Google ScholarPubMed
Haan, HH, Gunn, AJ, Williams, CE, et al. Magnesium sulfate therapy during asphyxia in near-term fetal lambs does not compromise the fetus but does not reduce cerebral injury. Am J Obstet Gynecol 1997; 176: 18–27.CrossRefGoogle Scholar
Penrice, J, Amess, PN, Punwani, S, et al. Magnesium sulfate after transient hypoxia–ischemia fails to prevent delayed cerebral energy failure in the newborn piglet. Pediatr Res 1997; 41: 443–7.CrossRefGoogle ScholarPubMed
Levene, M, Blennow, M, Whitelaw, A, et al. Acute effects of two different doses of magnesium sulphate in infants with birth asphyxia. Arch Dis Child Fetal Neonatal Ed 1995; 73: F174–7.CrossRefGoogle ScholarPubMed
Robertson, NJ, Edwards, AD. Recent advances in developing neuroprotective strategies for perinatal asphyxia. Curr Opin Pediatr 1998; 10: 575–80.CrossRefGoogle ScholarPubMed
Marret, S, Doyle, LW, Crowther, CA, et al. Antenatal magnesium sulphate neuroprotection in the preterm infant. Semin Fetal Neonatal Med 2007; 12: 311–17.CrossRefGoogle ScholarPubMed
Crowther, CA, Hiller, JE, Doyle, LW, et al. Effect of magnesium sulfate given for neuroprotection before preterm birth: a randomized controlled trial. JAMA 2003; 290: 2669–76.CrossRefGoogle ScholarPubMed
Gunn, AJ, Mydlar, T, Bennet, L, et al. The neuroprotective actions of a calcium channel antagonist, flunarizine, in the infant rat. Pediatr Res 1989; 25: 573–6.CrossRefGoogle ScholarPubMed
Gunn, AJ, Williams, CE, Mallard, EC, et al. Flunarizine, a calcium channel antagonist, is partially prophylactically neuroprotective in hypoxic–ischemic encephalopathy in the fetal sheep. Pediatr Res 1994; 35: 657–63.CrossRefGoogle ScholarPubMed
Levene, MI, Gibson, NA, Fenton, AC, et al. The use of a calcium-channel blocker, nicardipine, for severely asphyxiated newborn infants. Dev Med Child Neurol 1990; 32: 567–74.CrossRefGoogle ScholarPubMed
Buonocore, G, Groenendaal, F. Anti-oxidant strategies. Semin Fetal Neonatal Med 2007; 12: 287–95.CrossRefGoogle ScholarPubMed
Palmer, C, Towfighi, J, Roberts, RL, et al. Allopurinol administered after inducing hypoxia–ischemia reduces brain injury in 7-day-old rats. Pediatr Res 1993; 33: 405–11.Google ScholarPubMed
Bel, F, Shadid, M, Moison, RM, et al. Effect of allopurinol on postasphyxial free radical formation, cerebral hemodynamics, and electrical brain activity. Pediatrics 1998; 101: 185–93.Google ScholarPubMed
Benders, MJ, Bos, AF, Rademaker, CM, et al. Early postnatal allopurinol does not improve short term outcome after severe birth asphyxia. Arch Dis Child Fetal Neonatal Ed 2006; 91: F163–5.CrossRefGoogle Scholar
Gunes, T, Ozturk, MA, Koklu, E, et al. Effect of allopurinol supplementation on nitric oxide levels in asphyxiated newborns. Pediatr Neurol 2007; 36: 17–24.CrossRefGoogle ScholarPubMed
Tan, WK, Williams, CE, Mallard, CE, et al. Monosialoganglioside GM1 treatment after a hypoxic–ischemic episode reduces the vulnerability of the fetal sheep brain to subsequent injuries. Am J Obstet Gynecol 1994; 170: 663–9.CrossRefGoogle ScholarPubMed
Hall, ED. The neuroprotective pharmacology of methylprednisolone. J Neurosurg 1992; 76: 13–22.CrossRefGoogle ScholarPubMed
Amar, AP, Levy, ML. Pathogenesis and pharmacological strategies for mitigating secondary damage in acute spinal cord injury. Neurosurgery 1999; 44: 1027–3.CrossRefGoogle ScholarPubMed
Hall, ED, McCall, JM, Means, ED. Therapeutic potential of the lazaroids (21-aminosteroids) in acute central nervous system trauma, ischemia and subarachnoid hemorrhage. Adv Pharmacol 1994; 28: 221–68.CrossRefGoogle ScholarPubMed
Kavanagh, RJ, Kam, PC. Lazaroids: efficacy and mechanism of action of the 21-aminosteroids in neuroprotection. Br J Anaesth 2001; 86: 110–19.CrossRefGoogle ScholarPubMed
McPherson, RJ, Juul, SE. Recent trends in erythropoietin-mediated neuroprotection. Int J Dev Neurosci 2008; 26: 103–11.CrossRefGoogle ScholarPubMed
Gonzalez, FF, McQuillen, P, Mu, D, et al. Erythropoietin enhances long-term neuroprotection and neurogenesis in neonatal stroke. Dev Neurosci 2007; 29: 321–30.CrossRefGoogle ScholarPubMed
Adamson, SJ, Alessandri, LM, Badawi, N, et al. Predictors of neonatal encephalopathy in full-term infants. BMJ 1995; 311: 598–602.CrossRefGoogle ScholarPubMed
Badawi, N, Kurinczuk, JJ, Keogh, JM, et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case–control study. BMJ 1998; 317: 1554–8.CrossRefGoogle ScholarPubMed
Shankaran, S. The postnatal management of the asphyxiated term infant. Clin Perinatol 2002; 29: 675–92.CrossRefGoogle ScholarPubMed

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