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Therapeutic hypothermia is the standard treatment for hypoxic-ischemic encephalopathy (HIE), but despite its widespread use, the rates of mortality and neurodevelopmental impairment for moderate to severe HIE remain around 30%. Methylxanthines, such as caffeine and aminophylline, have potential neuroprotective effects in the setting of hypoxic-ischemic injury. However, data on the safety and efficacy of methylxanthines in the setting of therapeutic hypothermia for HIE are limited. This retrospective multicenter study examined in-hospital outcomes in 52 infants with HIE receiving methylxanthines and therapeutic hypothermia. The frequency of mortality and in-hospital morbidities were similar to those of infants enrolled in clinical trials undergoing therapeutic hypothermia without adjunctive therapies. Clinical trials of methylxanthines for neuroprotection in HIE are needed to determine safety and efficacy and should explore optimal dosing and timing of methylxanthine administration.
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http://dx.doi.org/10.1038/s41598-024-70410-w | DOI Listing |
Arq Bras Cardiol
September 2025
Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Targeted temperature management (TTM) is currently the only potentially neuroprotective intervention recommended for post-cardiac arrest care. However, there are concerns among the scientific community regarding conflicting evidence supporting this recommendation. Moreover, the bulk of trials included in systematic reviews that inform guidelines and recommendations have been conducted in developed countries, with case mix and patient characteristics that significantly differ from the reality of developing countries such as Brazil.
View Article and Find Full Text PDFMedicine (Baltimore)
September 2025
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, South Korea.
This study aimed to investigate the clinical course of brain death donors and admitted through the emergency department before organ procurement and early outcomes of kidney transplantation. We retrospectively reviewed the medical records of patients who visited a single tertiary emergency department with the final diagnosis of brain death and donor procurement between January 2013 and January 2022. Donors were categorized into 3 groups: brain hemorrhage, hanging, and other medical causes.
View Article and Find Full Text PDFAsian Cardiovasc Thorac Ann
September 2025
Cardiothoracic Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
BackgroundThe optimal cerebral protection strategy during complex aortic surgery remains controversial, and various brain monitoring modalities are used to provide different information to improve cerebral protection. This study aims to compare the effect of the change in cerebral oxygen saturation during hypothermic circulatory arrest on the early postoperative neurological outcome in antegrade cerebral perfusion (ACP) versus retrograde cerebral perfusion (RCP) during circulatory arrest in adult aortic surgery using cerebral oximetry.MethodsThis was a cross-sectional analytic study that enrolled a total of 84 patients undergoing total circulatory arrest during adult aortic surgery divided into two groups.
View Article and Find Full Text PDFJAMIA Open
October 2025
Fetal-Neonatal Neuroimaging Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Objectives: To develop a data harmonization framework for neonatal hypoxic-ischemic encephalopathy (HIE) studies and demonstrate its suitability for prognostic biomarker development.
Materials And Methods: Variables were first categorized by chronological stages and then by medical topics. We created a dictionary to harmonize variable names and value coding.
Baichuan Baile (BCBL) is a novel formula that incorporates three herbs and a single food additive, all of which are widely used in ordinary or functional foods. It is a promising dietary supplement for the treatment of depression based on TCM principles and nutritional assessments. Our study was designed to explore BCBL's antidepressant-like effects and elucidate its underlying mechanisms.
View Article and Find Full Text PDF