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

Allopurinol

Allopurinol is an antioxidant that inhibits formation of the free radicals that play such a significant role in the cellular damage associated with HIE.[6] When administered to neonatal rats with HIE, allopurinol decreased the amount of subsequent brain damage.[27] In addition, when term infants with HIE received allopurinol within 3 hours after birth, there was less free radical formation.[28] Although some small trials have indicated a more favorable outcome after allopurinol administration, recent meta-analysis findings indicated that insufficient data existed to support allopurinol as an effective treatment of HIE.[29] Thus, additional research is needed to determine the effectiveness of treating infants with this innovative therapy. Administration of allopurinol to mothers whose pregnancies are complicated by fetal hypoxia, however, has been associated with improved cord gases, and a large multicenter randomized control trial is currently underway to examine the effect of prenatal administration of allopurinol to fetuses at risk for HIE.[30,31] Because it appears early treatment with allopurinol is optimal, prenatal treatment with placental transfer to the fetus may be the most viable option.

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