Pentoxifylline use for neuroprotection in neonates with hypoxic ischemic encephalopathy

Abstract

Background: Pentoxifylline has been used in neonates with diseases related to inflammation, free radical toxicity, or impaired microcirculation. It also showed neuroprotective effect in animal studies. Aim: to study the short‐term effects of pentoxifylline on clinical and oxidative stress in neonates with hypoxic‐ischemic encephalopathy (HIE). Patients and Methods: we conducted a prospective randomized control study on 20 neonates > 36 weeks gestation, diagnosed as HIE (12 sever and 8 moderate HIE). Neonates were randomized into: pentoxifylline/hypothermia group (n=10; received hypothermia and intravenous pentoxifylline once daily for 3 successive days) and hypothermia group (n=10 received hypothermia and an equivalent dose of placebo). cranial ultrasound and amplitude EEG were done at enrollment. Serum malondialdehyde (MDA) was measured before enrollment and at day 7. Results: MDA is higher in stage III HIE compared to stage II and in non‐survivors compared to survivors (P<0.001). mortality in the hypothermia group is double the pentoxifylline/hypothermia group. We found no statistical difference between the two groups regarding short‐term clinical outcome or serum MDA. Conclusion: Pentoxifylline combined with hypothermia therapy of great value in HIE neonates.