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Erythropoietin for infants with hypoxic-ischemic encephalopathy McPherson RJ; Juul SECurr Opin Pediatr 2010[Apr]; 22 (2): 139-45PURPOSE OF REVIEW: Perinatal asphyxia, intraventricular hemorrhage and stroke are common causes of neonatal brain injury, with hypoxia-ischemia as the final common pathway of injury. Erythropoietin (Epo) has potential to lessen neurologic sequelae due to hypoxia-ischemia. The purpose of this review is to highlight new clinical trials and experimental evidence that expand our understanding of Epo as a potential treatment for perinatal brain injury. RECENT FINDINGS: Several trials of Epo treatment are reviewed: two phase I/II trials of high-dose Epo given to preterm infants established pharmacokinetic and safety profiles, and a trial of Epo treatment for term infants with moderate hypoxic-ischemic encephalopathy found reduced disability. Potential risks and benefits of high-dose Epo are discussed. New evidence related to Epo receptor expression, signal transduction pathways, and mechanisms of neuroprotection are reviewed. SUMMARY: Cautious optimism is warranted regarding the use of high-dose Epo as a treatment option for neonatal brain injury. To date, Epo has been well tolerated to use in neonatal populations and now studies of neuroprotective efficacy are underway.|Erythropoietin/*therapeutic use[MESH]|Humans[MESH]|Hypoxia-Ischemia, Brain/*drug therapy[MESH]|Infant, Newborn[MESH]|Infant, Premature[MESH] |
