Neuroprotective Strategies for Hypoxic Ischemic Encephalopathy

Leslie Parker, PhD, NNP-BC; Carole Kenner, DNS, RNC-NIC, FAAN

Disclosures

NAINR. 2012;12(1):8-11. 

In This Article

Magnesium Sulfate

Magnesium sulfate (MgSO4), traditionally used for the treatment of pregnancy-induced hypertension and prevention of preterm labor, is being investigated as a neuroprotective agent for infants with HIE. Magnesium sulfate is an N-methyl-D-aspartate receptor antagonist. N-methyl-D-aspartate is a receptor for glutamate, an amino acid important in cell proliferation, differential, and survival in the developing brain. With HIE, glutamate accumulates in abnormally high levels, resulting in neuronal cell injury and death.[23] Conflicting data exist regarding the effectiveness of MgSO4 as a neuroprotective agent. Prenatal administration of MgSO4 to mothers at risk for preterm delivery is associated with reduced incidence of cerebral palsy at 3 years and improved neurodevelopmental outcomes.[24,25] However, these benefits are not universal. When MgSO4 was administered postnatally to term infants with HIE, there was no improvement in their amplitude-integrated EEG, and when administered in large doses, MgSO4 can cause profound hypotension.[26]

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