O-057 Melatonin As A Novel Neuroprotectant In Preterm Infants – A Double Blinded Randomised Controlled Trial (mint Study)

Merchant, Nazakat; Azzopardi, Denis; Counsell, Serena J.; Gressèns, Pierre; Dierl, A; Gozar, I; Kapetanakis, A; Wan, Mandy; Ball, Gareth; Rutherford, Mary; Sharma, Medha; Allsop, JM; Fox, Matthew; Jani, B; Palaniappan, S; Bisson, Isabelle; Edwards, AD

doi:10.1136/archdischild-2014-307384.125

Cited by 18 publications

(10 citation statements)

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“…Из фармакологических нейропротекторов, чья роль в индукции нейропластических процессов может считаться доказанной, у недоношенных детей широко применяется эритропоэтин -причем независимо от режимов и дозировок препарата мультицентровые метааналитические исследования свидетельствуют о более высоком уровне интеллекта в возрасте 18 месяцев у недоношенных при использовании эритропоэтина в первые 48 часов после рождения (оценка когнитивных функций проводилась по шкале Бейли) [40]. В начальной стадии находятся клинические исследования применения с нейропротективной целью у недоношенных мелатонина [41]; в стадии эксперимента -изучение креатина [42], гранулоцитарного колониестимулирующего фактора [43], полусинтетического антибиотика миноциклина [44], эпидермального ростового фактора [45] и диазоксида [46]. Обсуждаются различные инновационные методы возможной доставки нейропротекторов (т.н.…”

Section: оритн и векторы постнатального развития недоношенного младенцаunclassified

Predictors of Cognitive Defects and Its Prevention Capabilities in Premature Infants

Беляева¹,

Баранов²,

Намазова-Баранова³

et al. 2020

Pediatr. farmakol.

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The article summarizes the materials of modern publications on cognitive development of premature infants in connection with perinatal factors and parenting conditions. Leading risk predictors of cognitive defects in premature infants are severe dysmaturity by the time of birth (gestational age <27 weeks) and need for intensive care during the first weeks of life. The data of longitudinal researches of the premature infants’ development until reaching their adulthood is presented. The structure of cognitive defects in this population is studied. The most common problems were revealed in learning mathematics, operational memory and purposeful behavior and activity. Frequency of these cognitive defects is associated with both: stage of prematurity social problems of the family. Modern neurovisualization methods (diffusion weighted imaging and functional magnetic resonance imaging (MRI) of the brain) allows to identify the defects in child nervous system (Connectome) development already at the age of 18 months. It can be the substrate of cognitive defects, and it will allow to predict individual development pathway and implement direct corrections and interventions.

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Section: оритн и векторы постнатального развития недоношенного младенцаunclassified

Predictors of Cognitive Defects and Its Prevention Capabilities in Premature Infants

Беляева¹,

Баранов²,

Намазова-Баранова³

et al. 2020

Pediatr. farmakol.

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“…Було зроблено висновок про те, що нервові центри, відповідні за генерацію біоритмів та гормональний імритинг пінеальнї залози, не спроможні прискорити свій розвиток після передчасних пологів [17]. У 2013 році при проведенні дослідження фармакокінетики мелатоніну у 16 дітей, народжених до 31 тижня гестації, базові рівні його у сироватці визначалися як низькі або не визначалися зовсім [18].…”

Section: вступunclassified

“…протягом 2 годин) було підібрано для досягнення цільової концентрації у сироватці відповідно до рівню мелатоніну у дорослих. Під час проведення магнітно-резонансної томографії білої речовини в еквівалентному скоригованому віці не було виявлено різниці між групами [46]. Однак відсутність позитивного ефекту може бути пояснено порівняно низькою дозою, що вводилася в цьому дослідженні [47].…”

Section: вступunclassified

New Definitions in the Management of Neonates With Oxidative Stress Diseases

Klymenko¹,

Kuzenkova²

2020

Neonatol. hìr. perinat. med.

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“…It was found that peak adult melatonin concentration could be achieved by a relatively short (2 h) infusion of low dose (0.1 μg/kg/h) melatonin in preterm infants (Merchant et al, 2013). Using this dosing regime, a Phase 2 RCT (The Mint Study) was conducted to evaluate the neuroprotective effect of melatonin in 58 preterm infants (30 received melatonin and 28 received placebo) (Merchant et al, 2014). No between group difference was shown for the primary outcome, which was a 5% difference in the fractional anisotropy in the white matter measured using MRI at term equivalent age.…”

Section: Emergent Interventionsmentioning

confidence: 99%

Emergent Prophylactic, Reparative and Restorative Brain Interventions for Infants Born Preterm With Cerebral Palsy

et al. 2019

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Worldwide, an estimated 15 million babies are born preterm (<37 weeks' gestation) every year. Despite significant improvements in survival rates, preterm infants often face a lifetime of neurodevelopmental disability including cognitive, behavioral, and motor impairments. Indeed, prematurity remains the largest risk factor for the development of cerebral palsy. The developing brain of the preterm infant is particularly fragile; preterm babies exhibit varying severities of cerebral palsy arising from reductions in both cerebral white and gray matter volumes, as well as altered brain microstructure and connectivity. Current intensive care therapies aim to optimize cardiovascular and respiratory function to protect the brain from injury by preserving oxygenation and blood flow. If a brain injury does occur, definitive diagnosis of cerebral palsy in the first few hours and weeks of life is difficult, especially when the lesions are subtle and not apparent on cranial ultrasound. However, early diagnosis of mildly affected infants is critical, because these are the patients most likely to respond to emergent treatments inducing neuroplasticity via high-intensity motor training programs and regenerative therapies involving stem cells. A current controversy is whether to test universal treatment in all infants at risk of brain injury, accepting that some patients never required treatment, because the perceived potential benefits outweigh the risk of harm. Versus, waiting for a diagnosis before commencing targeted treatment for infants with a brain injury, and potentially missing the therapeutic window. In this review, we discuss the emerging prophylactic, reparative, and restorative brain interventions for infants born preterm, who are at high risk of developing cerebral palsy. We examine the current evidence, considering the timing of the intervention with relation to the proposed mechanism/s of action. Finally, we consider the development of novel markers of preterm brain injury, which will undoubtedly lead to improved diagnostic and prognostic capability, and more accurate instruments to assess the efficacy of emerging interventions for this most vulnerable group of infants.

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O-057 Melatonin As A Novel Neuroprotectant In Preterm Infants – A Double Blinded Randomised Controlled Trial (mint Study)

Cited by 18 publications

References 1 publication

Predictors of Cognitive Defects and Its Prevention Capabilities in Premature Infants

Predictors of Cognitive Defects and Its Prevention Capabilities in Premature Infants

New Definitions in the Management of Neonates With Oxidative Stress Diseases

Emergent Prophylactic, Reparative and Restorative Brain Interventions for Infants Born Preterm With Cerebral Palsy

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