Neonatal Hypoxic-Ischemic Encephalopathy: Advances in Therapeutic Hypothermia and Biomaker Research

Authors

  • Gayatri Katole
  • Suresh Kumar Gautam
  • Archana Shaha
  • Amol Uttamrao Borade
  • Ajay Kharche
  • Deepak Panjwani
  • Jai Narayan Mishra
  • Basavaraj H

Keywords:

Antioxidants, Biomarkers, Encephalopathy, Hypoxia, Inflammation, Magnetic Resonance Imaging, Neonatal Brain Injury, Neurodevelopment, Oxidative Stress, Therapeutic Hypothermia, Urinary Biomarkers, White Matter

Abstract

Neonatal hypoxic-ischemic encephalopathy (HIE) is a serious condition resulting from insufficient oxygen and blood flow to the neonatal brain, leading to significant morbidity and mortality worldwide. Therapeutic hypothermia (TH) remains the only established treatment, offering neuroprotection by reducing cerebral metabolism, excitotoxicity, and inflammation, thereby improving survival and neurological outcomes. However, despite its benefits, a substantial proportion of infants treated with TH still experience death or long-term neurodevelopmental disabilities, highlighting the need for optimized therapies and adjunctive treatments. Recent advances have focused on understanding the complex pathophysiology of HIE, including phases of primary and secondary energy failure, oxidative stress, and neuroinflammation, which are critical for guiding intervention timing and development. Concurrently, biomarker research is rapidly evolving to identify reliable indicators of brain injury severity and progression, with promising candidates including neuroproteins, microRNAs, and inflammatory mediators. These biomarkers aim to enable early diagnosis, prognostication, and personalized treatment strategies. This review summarizes current therapeutic hypothermia protocols, explores novel adjunct therapies under clinical evaluation, and highlights emerging biomarker discoveries that hold potential to transform the management and outcomes of neonatal HIE. Further research and clinical trials are essential to improve neuroprotection and reduce the long-term impacts of HIE.

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Published

2025-04-23

How to Cite

1.
Katole G, Gautam SK, Shaha A, Borade AU, Kharche A, Panjwani D, Mishra JN, Basavaraj H BH. Neonatal Hypoxic-Ischemic Encephalopathy: Advances in Therapeutic Hypothermia and Biomaker Research. J Neonatal Surg [Internet]. 2025Apr.23 [cited 2025Sep.20];14(17S):15-22. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/4417

Issue

Vol. 14 No. 17S (2025): Journal of Neonatal Surgery

Section

Original Article

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