title: Single dose recombinant erythropoietin versus moderate hypothermia for neonatal hypoxic ischemic encephalopathy in low resource settings.
abstract: OBJECTIVE
  To determine the safety and efficacy of single dose systemic recombinant human erythropoietin (rEPO) in neonates with perinatal hypoxic Ischemic Encephalopathy (HIE), and its effect on serum brain-derived neurotrophic factor (BDNF) and neuron-specific enolase (NSE).
  
  
  METHODS
  Forty-five full-term neonates; 30 with perinatal HIE and 15 controls were studied. HIE neonates were randomized into three intervention groups (first 6 h of life): 10 received single subcutaneous 1500 U/kg rEPO at day-1, 10 subjected to hypothermia for 72 h and 10 received supportive care. BDNF and NSE measured during first 6 h and day 5 postnatal. Daily Thompson's score, MRI brain and neuromuscular function scale for survivors at 3 months of age were done.
  
  
  RESULTS
  Hypothermia group had best survival especially with stage-II Sarnat scale, followed by rEpo and supportive group. BDNF day-5 was significantly higher in each group compared to controls. MRI score and neuromuscular function score were non-significantly lower in the hypothermia group compared to rEPO.
  
  
  CONCLUSIONS
  Therapeutic hypothermia was superior to single dose rEpo for neuro-protection in HIE especially in patients with stage-II Sarnat scale. Therapeutic effect of combined rEPO multiple dosing and modest hypothermia therapy should be studied.
authors.affiliation: Department of Paediatrics and.
authors.forename: M Sami
authors.initials: MS
authors.lastname: El Shimi
authors.forename: Hisham A
authors.initials: HA
authors.lastname: Awad
authors.forename: Sahar M A
authors.initials: SM
authors.lastname: Hassanein
authors.forename: Ghada I
authors.initials: GI
authors.lastname: Gad
authors.forename: Safaa S
authors.initials: SS
authors.lastname: Imam
authors.forename: Hebatallah A
authors.initials: HA
authors.lastname: Shaaban
authors.forename: Mohamed O
authors.initials: MO
authors.lastname: El Maraghy
mesh_terms: D016022:Case-Control Studies; D003906:Developing Countries; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000188:drug therapy*; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D004921:Erythropoietin
keywords: Brain-derived neurotrophic factor; erythropoietin; hypothermia; neurone-specific enolase; perinatal hypoxia