Resuscitation of the asphyxic newborn infant: new insight leads to new therapeutic possibilities.
The basic mechanisms leading to cell death in birth asphyxia are becoming better known. Some of these are excitotoxicity, inflammation and oxidative stress. In the so-called therapeutic window - between the primary and secondary energy failure - modulation of these processes may be beneficial, reducing apoptosis and perhaps necrosis. In order to reduce oxidative stress, reoxygenation with low oxygen concentrations, even as low as room air, might be beneficial. Increased oxidative stress might have long-term effects on brain growth and development and there is evidence indicating that exposure to 100% oxygen after birth for only a few minutes might have long-term effects. New guidelines for newborn resuscitation have recently been published but more research is needed in this field, especially regarding resuscitation of preterm infants, where few data exist.
Department of Pediatric Research, The National Hospital, University of Oslo, Norway. o.d.saugstad@klinmed.uio.no
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D001238:Asphyxia Neonatorum / Q000628:therapy*; D001921:Brain / Q000254:growth & development; D004734:Energy Metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018384:Oxidative Stress; D010100:Oxygen / Q000008:administration & dosage / Q000009:adverse effects; D017382:Reactive Oxygen Species / Q000378:metabolism; D012151:Resuscitation / Q000379:methods*
D017382:Reactive Oxygen Species; D010100:Oxygen